>> WELCOME, EVERYONE.
THIS IS THE THIRD TALK SPONSORED
WORKSHOP, FOCUSING ON
TRANSLATING RESEARCH INTO
PRACTICE.
I'M HOLLY STORKEL.
I'M THE PROGRAM OFFICER FOR
LANGUAGE AT THE NATIONAL
INSTITUTE ON DEAFNESS AND OTHER
COMMUNICATION DISORDERS, OR
NIDCD.
I'M ALSO A MEMBER OF THE TALK
LEADERSHIP TEAM.
NEXT SLIDE PLEASE.
WITH APOLOGIES TO THOSE WHO HAVE
BEEN WITH US FOR ALL THREE
WORKSHOPS, YOU'RE GOING TO BE
EXPERTS IN WHAT IS TALK.
FOR ANYONE WHO IS NEW TO JOINING
US, I WANT TO MAKE SURE EVERYONE
KNOWS WHAT TALK IS.
FIRST OF ALL, TALK STANDS FOR
TACKLING ACQUISITION OF LANGUAGE
IN KIDS.
THIS IS A MULTI-INSTITUTE
INITIATIVE AT NIH, LAUNCHED
RECENTLY IN FEBRUARY OF 2023.
THE INTENT OF TALK IS TO
UNDERSTAND WHY CHILDREN ARE LATE
TO TALK.
WHAT FACTORS DIFFERENTIATE
CHILDREN WHO WILL CONTINUE TO
STRUGGLE WITH LANGUAGE VERSUS
THOSE WHO WON'T, AND HOW WE CAN
BEST SUPPORT LATE-TALKING
CHILDREN TO IMPROVE THEIR
OUTCOMES.
THE ULTIMATE GOAL OF TALK IS TO
PROVIDE PARENTS AND CAREGIVERS
AND OTHER PROFESSIONALS WITH THE
INFORMATION THEY NEED TO BETTER
SUPPORT THESE CHILDREN.
NEXT SLIDE.
WE USE A BROAD AND INCLUSIVE
DEFINITION OF LATE TALKING,
SPECIFICALLY ANY CHILD NOT
MEETING EXPRESSIVE LANGUAGE
MILESTONES AT ABOUT 18 MONTHS OF
AGE FOR ANY REASON, CONDITION,
RISK FACTOR.
PRETTY MUCH ALL CHILDREN BECAUSE
WE WANT TYPICALLY DEVELOPING
CHILDREN AS A COMPARISON GROUP
TO THE CHILDREN WHO STRUGGLE.
AS MANY OF YOU KNOW FROM THIS
COMMON STARTING POINT, THERE ARE
A VARIETY OF OUTCOMES.
SOME CHILDREN SEEMINGLY LEARN
LANGUAGE AT A FASTER RATE THAN
PEERS, AND APPEAR TO CATCH UP TO
THEIR PEER GROUP ON THEIR
LANGUAGE MILESTONES.
OTHER LAG BEHIND THE SAME AN AGE
PEERS IN LANGUAGE DEVELOPMENT
FOR EXTENDED PERIODS OF TIME,
SOME MAY NOT BE COMMUNICATE
THROUGH SPOKEN LANGUAGE AT ALL
AND NEED ALTERNATIVE MEANS OF
COMMUNICATION.
NOPE.
TALK HAS THREE TEAMS FOR ACTION
WHICH HAVE GUIDED THIS WORKSHOP
SERIES.
LONGITUDINAL THEME IS ABOUT
UNDERSTANDING THESE PATHWAYS
INTO AND THROUGH THE LATE TALKER
BENCHMARK TO UNDERSTAND THE WAYS
CHILDREN LEARN LANGUAGE, ON TIME
OR BEHIND SCHEDULE.
OUR NOVEL APPROACHES THEME IS
ABOUT APPLYING NEW AREAS OF
SCIENCE AND TECHNOLOGY TO
PROVIDE NOVEL INSIGHTS INTO THIS
GROUP OF CHILDREN.
TRANSLATIONAL THEME, THE FOCUS
OF TODAY, IS ABOUT CREATING AND
USING EVIDENCE BASE TO HELP
PARENTS AND PROFESSIONALS
EFFECTIVELY SUPPORT LATE-TALKING
CHILDREN.
NEXT SLIDE.
FOR TODAY'S AGENDA, WE'LL FIRST
HEAR BRIEF FLASH TALKS FROM FIVE
TALK-FUNDED INVESTIGATORS AND
WILL ENGAGE IN A PANEL
DISCUSSION ABOUT TRANSLATIONAL
RESEARCH.
THROUGHOUT BOTH ACTIVITIES, WE
INVITE OUR AUDIENCE MEMBERS TO
USE THE Q&A PANEL FOR QUESTIONS.
NOTICE THAT'S MORE TO THE RIGHT
OF YOUR LOWER TOOL BAR.
THE CHAT IS ALSO OPEN BUT WE'RE
USING THE CHAT ONLY FOR
TECHNICAL ISSUES, SO IF YOU HAVE
QUESTIONS OR COMMENTS THAT YOU
WANT THE PANELISTS TO SEE,
PLEASE DO BE SURE TO USE THE Q&A
FEATURE.
AND WITH THAT, LET'S SWITCH OUT
OUR SLIDES AND GET READY FOR OUR
FIRST FLASH TALK.
FIRST SPEAKER IS MICHAEL FULLER
FROM UNIVERSITY OF NORTH TEXAS,
AND HIS PROJECT IS COMMUNITY
VIABLE FAMILY-SCHOOL PARTNERSHIP
INTERVENTION FOR CHILDREN WITH
SOCIAL-COMMUNICATION DEFICITS IN
EARLY CHILDHOOD EDUCATION.
TAKE IT AWAY, MICHAEL.
>> THANK YOU, HOLLY.
CAN YOU HEAR ME OKAY?
>> YES.
>> OKAY, WONDERFUL.
SO THANKS FOR GIVING ME THE
CHANCE TO GIVE A QUICK RUNDOWN
OF OUR STUDY.
COMPLETED AT THE UNIVERSITY
NORTH TEXAS, WORKING WITH
DARRELL HULL, RESEARCH
METHODOLOGIST, AND SUSAN
NICHOLS, RESEARCH CLINICIANS,
TWO GRADUATE STUDENTS, GABY AND
ALI AND THREE CONSULTANTS.
NEXT SLIDE PLEASE.
SO, I'M AN AUTISM RESEARCHER.
IN THE AUTISM FIELD, OVER THE
LAST DECADE OR SO THERE HAVE
BEEN A NEW SET OF INTERVENTION
STRATEGIES, THE FIELD COALESCES
AROUND.
WHICH PROVIDES A NEW AND
FRUITFUL PARADIGM FOR EARLY
INTERVENTION RESEARCH, WE CALL
THEM THE NATURALISTIC
DEVELOPMENTAL BEHAVIORAL
INTERVENTIONS.
AND AS PART OF THIS FRAMEWORK OF
NDBIs, THERE HAVE BEEN A
SUBGROUP OF INTERVENTIONS THAT
USE THESE STRATEGIES THAT CIRCLE
AROUND NATURALISTIC TEACHING TO
TRAIN PARENTS SO THERE'S NDBI
PARENT COACHING INTERVENTIONS
AND THE FIELD HAS DONE A NICE
JOB UNDERSTANDING COMPONENTS AND
PERIPHERY, THINGS THAT CAN BE
ADAPTED AND CHANGED.
AT THE SAME TIME, THERE'S ALSO
CHILDREN'S EARLY CHILDHOOD
EDUCATIONAL PRACTICES, AND WHAT
WE NOTICE A VERY WELL ALIGNED
WITH NAEYC GUIDELINES, NOT
NECESSARILY IN RIGOR, FIDELITY,
PROBABLY NOT IN TERMS OF DOSING
OR INTENT BUT ALIGNED IN HOW
NAEYC AND NDBI FOLKS THINKS
ABOUT EARLY LEARNING AND
DEVELOPMENT, PRIORITIZE SOCIAL
EMOTIONAL LEARNING AND HOW
IMPORTANT IT IS TO ENGAGE
PARENTS IN CHILDREN'S LEARNING.
SO THIS PROJECT HAS TWO PARTS,
THE GOAL 1 TO ENGAGE
STAKEHOLDERS FROM EARLY
CHILDHOOD EDUCATION COMMUNITY TO
ADAPT NDBI INTERVENTIONS,
ESSENTIAL ELEMENTARIES FOR USE
IN EARLY -- ESSENTIAL ELEMENTS
AND GOAL 2 TO DO A FIELD TEST TO
FOCUS ON FEASIBILITY AND
FIDELITY AND ACCEPTABILITY OF
THIS MODEL.
NEXT SLIDE PLEASE.
SO, IN TERMS OF PROGRESS TODAY,
WE'VE COMPLETED ESSENTIALLY GOAL
1, WHICH IS WE'VE ENGAGED A
BROAD RANGE OF STAKEHOLDERS, WE
USED AN IMPLEMENTATION SCIENCE
FRAMEWORK, DYNAMIC ADAPTATION
PROCESS TO HELP US GUIDE OUR
ADAPTATIONS, AND THIS FRAMEWORK
REQUIRES OR ASKS US OR GUIDES US
TO WORK WITH STAKEHOLDERS ACROSS
MULTIPLE SYSTEMS AND ALSO AT
MULTIPLE LEVELS FROM WITHIN THE
ORGANIZATION SO FOR US THIS
MEANT WE LOOK FOR EARLY
CHILDHOOD SYSTEM LEADERS,
EDUCATION SERVICE CENTERS,
SCHOOL DISTRICT LEADERSHIP,
NON-PROFIT LEADERSHIP, SO WE HAD
SIX PARTICIPANTS FROM THAT
GROUP.
WE HAVE SIX EARLY CHILDHOOD
PROGRAM DIRECTORS AND
PRINCIPALS.
WE HAVE 11 EARLY CHILDHOOD
EDUCATION TEACHERS, 11 FAMILIES
OF CHILDREN WITH SOCIAL
COMMUNICATION CHALLENGES IN
EARLY CHILDHOOD.
WE ALSO WORKED WITH STAKEHOLDERS
FROM PUBLIC SCHOOL SYSTEMS, HEAD
START, PRIVATE CHILD CARE
PROGRAMS.
THEN WE USED THE STAKEHOLDER
INFORMATION TO ADAPT THE
INTERVENTION.
IN TERMS OF GOAL 2 WE STARTED
FINALIZING METHODS FOR
FEASIBILITY TRIAL, SO FAR
RECRUITED FIVE EARLY CHILDHOOD
PROGRAMS TO START OUR
FEASIBILITY TRIAL.
NEXT SLIDE PLEASE.
I'M GOING TO GIVE A GLIMPSE OF
WHAT WE GLEANED FROM THE
STAKEHOLDER INTERVIEWS AND HOW
TO ADAPT THESE STRATEGIES.
FIRST IN TERMS OF APPROACH, WHAT
THE STAKEHOLDERS TOLD US, THE
FOCUS OF PARENT ENGAGEMENT IN
EARLY CHILDHOOD EDUCATION SHOULD
NOT JUST BE ABOUT AUTISM BUT
ABOUT A BROADER SPECTRUM OF
CHILDREN WITH SOCIAL
COMMUNICATION VULNERABILITIES.
TWO, IN TERMS OF STAFF TRAINING
FORWARD, TEACHERS HAVE A LOT OF
EXPERIENCE WITH LEARNING AND
FELT THAT WAS NOT APPROPRIATE,
INSTEAD WE'RE DOING 3-HOUR
DIDACTIC WORKSHOP IN PERSON WITH
IMPLEMENTATION SUPPORT
THROUGHOUT THE PROJECT.
IN TERMS OF THE LEARNING FORMAT
FOR THE PARENTS, WE HEARD
TEACHERS TALK A LOT ABOUT HOW
IMPORTANT IT IS TO GIVE PARENTS
AN OPPORTUNITY TO PRACTICE
SKILLS, SO WE'RE FOLLOWING SORT
OF A PLAY GROUP FORMAT FOR OUR
INTERVENTIONS, TEACHERS TALKED
ABOUT DOSAGE, MAJOR BARRIER IS
LIMITED TIME FOR TEACHERS AND
ALSO FOR PARENTS, SO WE LIMIT
OUR SELF TO THREE PLAY GROUPS
OVER THE COURSE OF A SCHOOL
YEAR.
NEXT SLIDE PLEASE.
THERE'S ONE LAST SLIDE.
THE ONE BEFORE.
BRIEFLY IN TERMS OF CON TONIGHT
WHAT WE HEARD IS THAT TEACHERS
FELT OR STAKEHOLDERS FELT THAT
THE STRATEGY THEY WISH PARENTS
KNEW MORE ABOUT, BASIC
STRATEGIES FOR ENGAGING CHILDREN
WITH COMMUNICATION DELAYS.
THEY WEREN'T SO INTERESTED IN
TEACHING PARENTS SPECIFIC
PROMPTING OR REINFORCEMENT
STRATEGIES.
INSTEAD THE FOCUS SHOULD BE ON
STRATEGIES TO ENGAGE CHILDREN IN
ACTIVITIES THAT ARE FAMILIAR
ROUTINES IN THE HOME.
I'M GOING TO LEAVE IT AT THAT.
>> ALL RIGHT.
THANKS SO MUCH, MICHAEL.
VERY INTERESTING WORK.
AND IF ANYONE HAS QUESTIONS,
PLEASE FEEL FREE TO PUT THOSE IN
THE Q&A.
WE WILL HAVE A LITTLE BIT OF
TIME TO ANSWER QUESTIONS LIVE
AFTER WE GET THROUGH ALL THE
FLASH TALKS.
OUR SPEAKERS WILL ALSO ATTEMPT
TO ANSWER THINGS IN THE Q&A
PANEL JUST BY TYPING THEIR
RESPONSE AS WELL.
IF WE COULD GO TO THE NEXT SLIDE
FOR THE TITLE.
YES.
NEXT SPEAKERS ARE DANIEL BAGNER
AND DANIELA VACLAVIK, PARENTING
INTERVENTION ON CHILD EXPRESSIVE
LANGUAGE, INTERIM FINDINGS FROM
A RANDOMIZED CLINICAL TRIAL.
TAKE IT AWAY.
>> HI, EVERYONE.
THANK YOU FOR HAVING US.
NEXT SLIDE PLEASE.
THIS PROJECT CAPITALIZES ON THE
PANTHERS PROJECT, A LARGE
RANDOMIZED CLINICAL TRIAL FUNDED
BY NICHD EVALUATING INFANT
BEHAVIOR PROGRAM, IBP.
AND WE'RE EVALUATING THE
PREVENTIVE INTERVENTION FOR
UNDERSERVED AND UNDERREPRESENTED
FAMILIES, WITH CHILDREN AT RISK
OF DEVELOPING MORE SEVERE
PROBLEMATIC BEHAVIORS IN THE
FUTURE.
AND BOTH THE IBP AND ACTIVE
CONTROL GROUP, WHICH CONSISTS OF
SESSIONS ON CHILD DEVELOPMENT,
CONSISTS OF SIX WEEKLY SESSIONS,
FAMILIES ARE EVALUATED FIVE TIME
POINTS, BASELINE,
POST-INTERVENTION, AND FOUR,
EIGHT, AND TWELVE MONTHS POST
INTERVENTION FOLLOW-UP.
IN SEVERAL PILOT STUDIES WE
FOUND THAT THE IBP IMPROVED
CHILDHOOD BEHAVIOR BUT WE ALSO
SAW SIGNIFICANT IMPROVEMENT IN
CHILD LANGUAGE PRODUCTION.
GIVEN THAT ALL DATA IN PREVIOUS
STUDY WERE BASED ON OBSERVATION
OF CHILD LANGUAGE DURING A
STRUCTURED PARENT-CHILD PLAY
ACTIVITY, WE WANTED TO ADOPT A
MULTI-METHOD APPROACH TO
EVALUATING CHILD LANGUAGE.
AND BRIEFLY, ADDITIONAL GOALS
INCLUDE EVALUATING MODERATION,
ONCE WE CAN HAVE THE NECESSARY
POWER TO DETECT.
NEXT SLIDE PLEASE.
TO THIS GOAL WE INCLUDED 200
FAMILIES BY THE END OF THE YEAR,
IN LINE WITH ADOPTING A
MULTI-METHOD APPROACH TO
EVALUATE LANGUAGE OUTCOMES
BECAUSE OF OUR INTEREST IN
LANGUAGE WE STARTED COLLECTING
LANGUAGE DATA AT THE ONSET OF
THE PANTHERS PROJECT USING THE
MacARTHUR-BASED
COMMUNICATIVE INVENTORY, MBCDI,
A MEASURE OF CHILD EXPRESSIVE
LANGUAGE.
WE WANTED TO ADD A MEASURE OF
NATURALISTIC CHILD LANGUAGE,
WHICH REQUIRED ADDITIONAL
FUNDING, SUCH THAT WE STARTED
COLLECTING DATA USING THE
LANGUAGE ENVIRONMENT ANALYSIS,
LENA, HALFWAY INTO YEAR 3 OF THE
PANTHERS PROJECT.
NEXT SLIDE PLEASE.
AND NOW DAN WILL PRESENT ON
PROGRESS AND PRELIMINARY
FINDINGS.
>> GREAT, THANKS DANIELA.
A BRIEF UPDATE ON THE PROGRESS,
THIS SLIDE SHOWS AS SAID WE
STARTED COLLECTING DATA USING
MBCDI AT THE START OF THIS
PROJECT.
WE'RE ALMOST DONE COLLECTING
DATA PARTICULARLY AT BASELINE
AND POST.
WE HAVE A LITTLE BIT OF WAYS TO
GO FOR THE FOLLOW-UPS.
LENA IN LIGHTER COLORS, WE HAVE
A BIT MORE WAY TO GO BECAUSE WE
DIDN'T COLLECT DATA UNTIL THE
TRIAL WAS IN THE THIRD YEAR.
SO, WE WILL BE ABLE TO ANALYZE
AT A LATER TIME POINT.
NEXT SLIDE PLEASE.
SO TO DATE, OUR CURRENT SAMPLE
OF 172 FAMILIES, GOAL IS 200
WHICH WE HOPE TO RECRUIT BY THE
END OF THIS YEAR.
OUR CHILDREN ON AVERAGE TO DATE
ARE ABOUT 15 MONTHS OF AGE, A
LITTLE BIT OVER HALF ARE BOYS.
AND MOST OF OUR FAMILIES REPORT
BEING FROM HISPANIC OR LATINE
BACKGROUNDS WITH SOME DIVERSITY
IN RACE, AS YOU CAN SEE ON OUR
SLIDE.
IN ADDITION BECAUSE WE ARE
LOCATED IN MIAMI, FLORIDA, WITH
LARGE NUMBER OF BILINGUAL AND
DUAL SPEAKING FAMILIES, THE
MAJORITY DO SPEAK MORE THAN ONE
LANGUAGE AND IN PARTICULAR
MOSTLY ENGLISH AND SPANISH.
NEXT SLIDE PLEASE.
AND SO THIS IS A QUICK PEEK AT
OUR PRELIMINARY DATA.
THESE ARE DATA ACROSS ALL FIVE
TIME POINTS.
OUR DEPENDENT VARIABLE IS THE
TOTAL NUMBER OF CHILD WORDS
SPOKEN REPORTED ON THE MBCBI.
WHAT WE DID FOR CHILDREN EXPOSED
TO ENGLISH AND SPANISH TOTALED
THE TOTAL NUMBER OF WORDS IN
ENGLISH AND SPANISH BOTH.
WE DO ALREADY HAVE A MAIN
EFFECTIVE TIME, SO OVER TIME ALL
KIDS ARE INCREASING IN THEIR
LANGUAGE, NOT SURPRISING.
WE DON'T YET -- WE DIDN'T FIND A
SIGNIFICANT GROUP BY TIME
INTERACTION.
HOWEVER, OUR EFFECT SIZE WAS
FAIRLY LARGE, SUGGESTING ONCE WE
HAVE OUR COMPLETED DATA AT THOSE
FOLLOW-UP TIME POINTS WE'LL FIND
A SIGNIFICANT EFFECT.
THIS TREND AS YOU CAN SEE
BETWEEN THE CONTROL AND
TREATMENT GROUP IS CONSISTENT
WITH WHAT WE FOUND IN OUR
PREVIOUS PILOT WORK WHERE WE SEE
DIFFERENCES START TO EMERGE
AROUND THAT AGE OF 2, AROUND
THAT AGE OF THE LANGUAGE
EXPLOSION WE TYPICALLY SEE IN
LIT
LITERATURE.
I'LL LEAVE IT AT THAT.
>> CAN WE ADVANCE TO THE NEXT
SPEAKER'S TITLE SLIDE?
THERE WE GO.
NEXT UP IS KARLA WASHINGTON,
FROM THE UNIVERSITY OF TORONTO,
AND HER PROJECT IS
CHARACTERIZING LATE TALKING,
NEUROBIOLOGICAL AND BEHAVIORAL
INSIGHTS.
>> THANKS FOR BEING HERE TODAY.
SO OUR PROJECT WAS ABLE TO
EXAMINE NEUROBIOLOGICAL AND
BEHAVIORAL INSIGHTS INTO LATE
TALKING, THE TEAM OF RESEARCHERS
YOU CAN SEE HERE SUPPORTING ME
IN THIS ENDEAVOR.
OUR PRIMARY GRANT, LARGER GRANT,
WAS FOCUSED ON UNDERSTANDING
MEMORY AND LANGUAGE CONNECTION,
INCREASED SCORES BY WAY OF
PROCEDURAL CIRCUIT DEFICIT
HYPOTHESIS.
WE WANTED TO EXTEND THIS
THEORETICAL PERSPECTIVE
DOWNSTREAM TO AN EARLIER
POPULATION WHO ARE OFTEN -- SOME
ARE LATER DIAGNOSED WITH
DEVELOPMENTAL LANGUAGE
DISORDERS, OTHERS ARE NOT.
TWO GOALS, ONE TO TRY TO
UNDERSTAND MORE OF A MECHANISTIC
CHARACTERIZATION OF CONNECTIVITY
DIFFERENCES BETWEEN LATE TALKERS
AND TYPICALLY DEVELOPING PEERS.
AND THEN FOR THE SECOND GOAL WAS
TO INFORM TREATMENT-RELATED
CHANGES IN LATE TALKERS WHO
RECEIVED A FOCUSED FORM OF
INTERVENTION OVER TIME.
NEXT SLIDE PLEASE.
AND YOU CAN TAP ONE MORE TIME.
THANK YOU.
AND SO FOR OUR GOAL 1 -- OH, I
THINK THAT JUMPED AHEAD.
CAN WE GO BACK?
WE'RE IN GOAL 2.
THANK YOU.
YES, THANK YOU.
SO, FOR GOAL 1 WE HAVE ABOUT 13
DYADS TO DATE, ANOTHER 4 THAT
JUST AGREED.
SLOWLY BUT SURELY WE'RE MOVING
TOWARD THE GOAL OF 45 PAIRS.
22 MONTHS IN AGE LATE TALKERS,
TYPICALLY DEVELOPING PEER,
PRESCHOOLERS FOR GOAL 1
COMPLETED ONE DIFFUSION IMAGING
SESSION AS PART OF A 15-MINUTE
PROTOCOL, SLEEP OR AWAKE.
AND THEIR PARENTS COMPLETED
INTERVIEWS ABOUT THEIR TALKING,
USING TOOLS MacARTHUR BATES,
QUESTIONS ABOUT GRAMMAR, VOCAB,
FUNCTIONAL COMMUNICATION.
WE ASKED PARENTS A QUESTION TO
GATHER INSIGHTS INTO CONCERNS
ABOUT TALKING.
YOU CAN SEE OUR COMPLETION
RATES.
NEXT SLIDE PLEASE.
SO, FOR GOAL 2, WE APPLIED A
PRAGMATIC DESIGN, ABLE TO TAKE
ADVANTAGE OF AN EXISTING
WAITLIST OF PRESCHOOLERS,
ONTARIO PRESCHOOL SPEECH AND
LANGUAGE INITIATIVE.
WE HAD A GROUP OF CHILDREN
AWAITING TREATMENT, AND BUT WHAT
THEY GOT WHILE WAITING WAS MORE
OF A GENERAL SUGGESTION GROUP.
AND THEN OUR EXPERIMENTAL GROUP
HAD MORE INTENTIONAL TREATMENT
AS PART OF COMMUNITY EFFORTS,
WHETHER IT'S PARENT AND TOT, ONE
ON ONE, GROUP LEARNING.
INTERVENTION WAS SANDWICHED
BETWEEN PRE AND POST OVER A SIX
WEEK PERIOD AND A SIX WEEK
BREAK.
YOU CAN SEE OUR COMPLETION RATES
AT THE TOP RIGHT-HAND CORNER OF
THE SCREEN.
NEXT SLIDE PLEASE.
SO IN TERMS OF WHAT WE HAVE
FOUND FOR GOAL 1, JUST ONE POINT
IN TIME, WE DO HAVE SOME SUPPORT
FOR OUR HYPOTHESIS RELATED TO
PROCEDURAL LEARNING NETWORK.
SO WITHIN THE AREA OF THE MEMORY
THAT RELATES TO THE KNOW-HOW WE
DID FIND THERE WERE DIFFERENCES
BETWEEN TYPICALLY DEVELOPING
CHILDREN AND THEIR LATE-TALKING
PEERS, WHICH IS IN KEEPING WITH
OUR HYPOTHESIS, BOTH
LATE-TALKING GROUPS PERFORMED
SIMILARLY.
ONE MORE TAP PLEASE.
IN TERMS OF QUALITATIVE
FINDINGS, PARENTS OF CHILDREN
WHO ARE LATE TALKERS, THEMES
GENERATED MORE USE OF GESTURES
VERSUS MORE USE OF WORDS FOR
TYPICALLY DEVELOPING PEERS.
IN TERMS OF CONCERNS,
INTERESTING WE FOUND TYPICALLY
DEVELOPING PARENTS COMPARED
CHILDREN TO THEIR SIBLINGS OR
OTHER FAMILY MEMBERS TO
DETERMINE WHETHER OR NOT THEY
WERE CONCERNED ABOUT TALKING,
LATE-TALKING PARENTS COMPARED
CHILDREN TO MILESTONES WHERE
THEY EXPECTED THEIR CHILDREN TO
BE.
BEHAVIORALLY IN LINE WHAT WE
THOUGHT, LATE-TALKING CHILDREN
PERFORMED LESS IN NUMBER OF
WORDS, FORMS OF WORDS, COMPARED
TO PEERS.
FOR GOAL 2, WE HAVE SOME
PRELIMINARY SUPPORT FOR OUR
HYPOTHESIS THAT THERE ARE
CONNECTIVITY DIFFERENCES IN
FAVOR OF OUR EXPERIMENTAL GROUP,
SO LATE TALKERS WHO RECEIVED
INTERVENTION SHOWED GREATER
CONNECTIVITY THAN THOSE IN OUR
WAITLIST GROUP.
QUALITATIVE PARENTS OF LATE
TALKERS ACTUALLY TALKED MORE
ABOUT GROWTH VERSUS TYPICALLY
DEVELOPING PARENTS TALK MORE
ABOUT PROGRESSING ENJOYMENT IN
COMMUNICATION.
WHEREAS BOTH GROUPS REGARDLESS
OF WHICH GROUP THEY WERE
DEMONSTRATED CONCERNS ABOUT
MISARTICULATION, 22-MONTH-OLDS
ON AVERAGE, NOT SURPRISING.
ONE MORE TAP.
NEXT SLIDE PLEASE.
SO WHAT WE HAVE FOUND IS THAT
OVER A 12 WEEK APPEARED, 31%
INCREASE IN NUMBER OF WORDS IN
THE WAITLIST GROUP WHILE
RECEIVING ONE TO TWO GROUP
SESSIONS.
FOR OUR EXPERIMENTAL GROUP,
THERE WAS A 50% INCREASE IN WORD
FORMS, SO THERE WAS MORE
COMPLEXITY OBSERVED IN WHAT THEY
WERE ABLE TO PRODUCE.
SO PRELIMINARILY WE DO HAVE SOME
SUPPORT TO EXTEND PROCEDURAL
CIRCUIT DEFICIT HYPOTHESIS
DOWNSTREAM TO LATE TALKERS TO
UNDERSTAND THEIR LANGUAGE USE IN
TERMS OF MECHANISTIC AS WELL AS
ABILITY TO LEARN NEW WORDS AND
COMMUNICATION OVER TIME.
NEXT SLIDE.
THANK YOU VERY MUCH.
>> ALL RIGHT.
THANKS, KARLA.
NEXT SLIDE FOR OUR INTRO.
NEXT SPEAKER IS MARY ALT,
UNIVERSITY OF ARIZONA.
OUTCOMES FOR GROWNUP LATE
TALKERS.
GO AHEAD, MARY.
>> THANK YOU SO MUCH FOR HAVING
ME.
I'M HONORED TO SPEAK ON BEHALF
OF OUR TEAM, SEVERAL OF WHOM ARE
ON THE WEBINAR HERE TODAY.
AND JUST EXCITED TO SEE SO MANY
PEOPLE IN THIS SPACE.
NEXT SLIDE PLEASEMENT WE HAVE A
PARENT PROJECT CALLED VAULT,
WHICH IS AN INTERVENTION
DESIGNED ON PRINCIPLES OF
STATISTICAL LEARNING THAT WE
PROVIDE TO KIND OF, IF YOU WILL,
TRADITIONAL LATE TALKERS, AND
WHAT WE'VE BEEN DOING WITH THIS
PROJECT IS WE'VE BEEN FOLLOWING
UP WITH OUR FORMER PARTICIPANTS
FROM THE VAULT STUDY NOW
PRESCHOOL AGE OR OLDER, UP TO
10, TO SEE HOW THEY ARE DOING.
TWO GOALS FOR THIS SECTION, THE
FIRST ONE IS WE WANTED TO SEE
HOW MANY OF THESE LATE TALKERS,
FORMER LATE TALKERS, WOULD
DEMONSTRATE SIGNS OF LANGUAGE
IMPAIRMENT OR A CLEAR RISK FOR
OTHER DIAGNOSES AFTER
TODDLERHOOD.
LITERATURE CURRENTLY SUGGESTS
THAT ABOUT 10 TO 20% OF TODDLERS
GROW UP TO HAVE A DISORDER.
AND THIS KIND OF FEEDS THAT
WELL, LET'S JUST WAIT ATTITUDE
THAT HAPPENS OUT THERE.
WE WERE INTERESTED IN LOOKING AT
STRENGTHS AND CHALLENGES
RELATIVE TO A WIDE RANGE OF
THINGS, INCLUDING SPEECH,
LANGUAGE, LITERACY, COGNITIVE
SKILLS.
AND AS WE WERE LOOKING AT
LITERATURE WE DIDN'T SEE A LOT
OF THIS IN THE SAME GROUP OF
CHILDREN.
SO WE WERE CURIOUS JUST TO SEE
WHAT THAT LOOKED LIKE.
NEXT SLIDE PLEASE.
SO FAR WE'VE COLLECTED AND
ANALYZED DATA FOR 47 CHILDREN
OUT OF 67 CANDIDATES, GETTING
READY TO DISSEMINATE.
I THOUGHT IT WAS IMPORTANT TO
SHARE REPRESENTATIVENESS OF THAT
SAMPLE.
IF WE'RE GOING TO TALK ABOUT HOW
MANY KIDS CONTINUE, WE WANT TO
SEE IF THERE'S A SKEW.
YOU CAN SEE THE RATIOS ARE
PRETTY RELATIVELY EVEN ACROSS
THOSE CHILDREN WHO -- THOSE
FAMILIES WHO DECIDED TO ENROLL
IN OUR FOLLOW-UP TALK STUDY AND
THOSE WHO DECLINED.
AND ANOTHER THING I'LL THROW OUT
THERE, IN TERMS OF PERCENTAGE OF
CHILDREN WHO RESPONDED TO OUR
INTERVENTION, THAT WAS ABOUT THE
SAME ACROSS GROUPS TOO, ABOUT
70% OF KIDS WHO HAD ENROLLED
WERE CONSIDERED RESPONDED, 60%
WHO DECLINED.
WE WERE PLEASED TO SEE WE DIDN'T
HAVE A HUGE SKEW THAT WAY.
NEXT SLIDE PLEASE.
PRELIMINARY FINDINGS WERE
DIFFERENT FROM THE LITERATURE.
WE FOUND ABOUT HALF OF THE KIDS
THAT WE TESTED, TESTED AS
DISORDERED, USING TESTS WITH
STRONG PSYCHOMETRIC PROPERTIES
TO DIAGNOSE LANGUAGE DISORDERS.
FOR THE YOUNGER CHILDREN, THOSE
WHO WERE AGES 3 TO 5 YEARS AND 1
MONTHS USED A SPELT-P2, AND FOR
OTHERRER CHILDREN WE USED THE
TILLS.
WE HAD MORE CHILDREN DISORDERED
IN OUR OLDER GROUP THAN IN OUR
YOUNGER GROUP.
OF THE THREE CHILDREN WHO COULD
NOT TEST, TWO WERE CONSIDERED AT
RISK BECAUSE THEY HAD PROFOUND
SPEECH ISSUES THAT LED TO OUR
NOT BEING ABLE TO COMPLETE THE
LANGUAGE TESTING WITH THEM, AND
ONE WE REALLY DON'T KNOW.
THEY WERE NOT HAVING US, THAT'S
THEIR RIGHT.
NEXT SLIDE PLEASE.
IN TERMS OF SOME OF OUR OTHER
DESCRIPTIVE FINDINGS FROM THIS
POINT WE LOOKED AT THE GROUP OF
CHILDREN TESTING AS IMPAIRED
COMPARED TO THE GROUP OF
CHILDREN WHO WERE NOT TESTING AS
IMPAIRED.
AND THOSE WHO WERE IMPAIRED WERE
NOTABLY LOWER THAN THEIR PEERS,
ON READING AND LITERACY TASKS,
ESPECIALLY SPELLING.
OF COURSE, THAT'S GOING TO GEAR
TOWARDS THE OLDER CHILDREN.
WE WEREN'T ASKING 3-YEAR-OLDS TO
SPELL.
FOR LANGUAGE SAMPLE ANALYSIS WE
SAW THEY HAD DECREASED SCORES OR
MEASURES RELATED TO SYNTAX LIKE
NUMBER OF VERBS, SUBORDINATE
INDEX, AS WELL AS VERBAL
FLUENCY.
THEY WERE LOWER IN TERMS OF
STATIC VOCABULARY MEASURES,
ESPECIALLY EXPRESSIVE MEASURES.
AND THEIR SPEECH SCORES WERE
LOWER.
THEY DID SHOW RELATIVE STRENGTH,
MEANING THERE WAS NO DIFFERENCE
BETWEEN THE GROUPS IN VOCABULARY
IN TERMS OF NUMBER OF DIFFERENT
WORDS ON THE LANGUAGE SAMPLE
ANALYSIS, AND IN TERMS OF ALL
THE COGNITIVE MEASURES THAT WE
LOOKED AT.
NEXT SLIDE PLEASE.
SO WE'VE GOT OTHER THINGS GOING
ON WITH THIS.
AND WE'LL BE SHARING OUR DATA ON
LD BASE COMING UP VERY SHORTLY
SO PLEASE CONTACT US IF YOU'RE
INTERESTED.
>> THANKS SO MUCH, MARY.
NEXT SLIDE FOR OUR FINAL
SPEAKER.
NAOMI CASELLI FROM BOSTON
UNIVERSITY, DEVELOPING PROFILES
OF LATE SIGNERS.
>> THANK YOU.
IN RESEARCH WE OFTEN TALK ABOUT
LATE SIGNING BUT WE USUALLY NAME
SOMETHING DIFFERENT.
WE'RE THINKING OFTEN ABOUT KIDS
WHO HAVE LIMITED ACCESS TO SIGN
LANGUAGE ROLE MODELS SO
ACQUISITION IS A BIT DELAYED.
AND IN FACT BEING DEAF IS OFTEN
AN EXCLUSIONARY CRITERIA TO BE
CONSIDERED A LATE TALKER.
AND SO WHAT WE WANTED TO DO IS
THINK HERE ABOUT WHAT MIGHT --
WHAT LANGUAGE LEARNING MIGHT
LOOK LIKE AMONG CHILDREN WHO
HAVE LOTS OF LANGUAGE INPUT BUT
ARE STILL ON THE SLOWER SIDE TO
ACQUIRE LANGUAGE.
THAT'S IMPORTANT FOR A COUPLE
REASONS.
ONE, FOR IT'S KIDS THEMSELVES,
FAMILIES ARE OFTEN LOOKING FOR
WAYS OF SUPPORTING THEIR
CHILDREN.
IT'S IMPORTANT FOR OPPORTUNITIES
FOR DEVELOPING THEORETICAL
UNDERSTANDING OF WHAT'S GOING ON
IN LATE TALKING BECAUSE WE CAN
LOOK AT WHAT HAPPENS IN A
DIFFERENT MODALITY AND SEE IF
THE PATTERNS WE SEE ARE THE SAME
OR AS IS THE CASE IN SPOKEN
LANGUAGE OR IF IT'S DIFFERENT.
SOME DEAF CHILDREN DO EXPERIENCE
LANGUAGE DELAYS DESPITE EARLY
ASL EXPOSURE.
WE HAVE VERY LITTLE RESEARCH
THESE KIDS BECAUSE WE DON'T HAVE
GREAT ASSESSMENT TOOLS.
WE HAVE SOME FOR SOME PARTS OF
THE LANGUAGE, FOR SOME SUBSETS
OF KIDS.
BUT LANGUAGE ASSESSMENTS ARE A
BIG BARRIER TO THIS WORK.
SO OUR GOAL HERE WAS TO
DEVELOP -- DOCUMENT LANGUAGE
DEVELOPMENT TRAJECTORY OF LATE
SIGNERS, ENTAILING ASSESSMENTS
OF LANGUAGE SKILLS.
WE WANTED TO EXAMINE THE
COMPOSITION OF THEIR EARLY VOCAB
LEISURES, USING ASL CDI,
ADAPTATION WE MADE OF THE
MacARTHUR-BATES CDI AND
DEVELOPING LANGUAGE PROFILES OF
LATE SIGNERS.
NEXT SLIDE.
SO, SO FAR WE'VE DEVELOPED
MOREPHO SYNTAX TEST TO BE USED
WITH ELEMENTARY AGE CHILDREN.
WE'VE BUILT A PROTOCOL FOR
DEVELOPING SYNTAX, WORKING ON
DATA COLLECTION NOW.
WE'VE GOT ANALYSIS DONE OF THEIR
EARLY VOCABULARY COMPOSITION
WHICH I'LL SHARE A LITTLE BIT IN
A SECOND.
NEXT SLIDE.
SO WHAT WE'RE SEEING SO FAR IS
THE COMPOSITION OF LATE SIGNERS,
EARLY VOCABULARIES, IS DIFFERENT
THAN VOCABULARY-MATCHED OR
AGE-MATCHED PEERS, LESS
SENSITIVITIES TO ELECTRICAL
PROPERTIES WE KNOW TYPICALLY
DEVELOPING SIGNERS ARE QUITE
SENSITIVE TO SO THE TWO WE'VE
LOOKED AT HERE ARE SIGN
FREQUENCY AND HOW MUCH THE SIGN
RESEMBLES ITS MEANING, HOW MUCH
THE SIGN FORM LOOKS LIKE ITS
MEANING, WHICH IS A LITTLE BIT
DIFFERENT THAN WHAT WE SEE IN
SPOKEN LANGUAGE.
WE'RE WORKING TO SORT OUT WHY
THAT MIGHT BE.
IS IT THAT WE'RE SEEING A
MODALITY DIFFERENCE OR IS IT
THAT THERE ARE MEASUREMENT
THINGS GOING ON, FIGURING OUT
HOW TO MEASURE SOME OF THESE
PROPERTIES SO WE'RE TRYING TO
CHASE DOWN THOSE RIGHT NOW.
NEXT SLIDE.
RIGHT.
SO, ONE OF THE THINGS WE'VE BEEN
THINKING A LOT ABOUT IS HOW WE
TRANSLATE THIS RESEARCH INTO
PRACTICE.
SO DEAF KIDS ARE GEOGRAPHICALLY
DISPERSED, IT HAPPENS WELL
ONLINE SO WE'VE BEEN WORKING
HARD ON HOW TO DO, THAT HOW DO
WE GET INFORMATION INTO
FAMILIES' HANDS AND INTO
PRACTITIONERS' HANDS SO FOLKS
HAVE ACCESS TO RESEARCH FINDINGS
AND PROFESSIONAL DEVELOPMENT.
OFTEN THAT MEANS TRANSLATIONAL
RESEARCH IN BOTH SENSES OF THE
WORD, IN TERMS OF TRYING TO MAKE
THE RESEARCH ACCESSIBLE, AND
MAKING IT ACCESSIBLE IN SIGN
LANGUAGE, HOW TO DISSEMINATE
THIS WORK.
THE REALLY HUGE CRITICAL PIECE
MISS HEARING IS LANGUAGE
ASSESSMENTS.
THAT'S A BARRIER FOR RESEARCH
PROGRESS.
IT'S ALSO A REALLY BIG BARRIER
FOR CLINICIANS AND EDUCATORS
BECAUSE THERE AREN'T GREAT TOOLS
FOR FIGURING OUT WHERE A CHILD
IS, WITH RESPECT TO THEIR SORT
OF LANGUAGE ACQUISITION
MILESTONES IF WE DON'T HAVE
GREAT ASSESSMENT FOR SKILLS AND
AGES, THAT'S AN AREA WHERE WE'RE
SPENDING A LOT OF OUR ENERGY
THINKING ABOUT RIGHT NOW.
>> THANKS SO MUCH, NAOMI.
WE CAN TAKE THE SLIDES DOWN NOW.
WE HAVE A FEW MINUTES FOR SOME
LIVE QUESTIONS.
I SEE PEOPLE HAVE BEEN ACTIVE IN
THE Q&A.
THEY ARE ANSWERING QUESTIONS.
I HAVE A QUESTION I'D LIKE TO
DIRECT TO MICHAEL SILLER.
A NUMBER OF TALK INITIATIVES
ENCOURAGE A COMMUNITY-ENGAGED
RESEARCH APPROACH.
WHICH YOU USED.
SO I WONDER IF YOU COULD TALK A
LITTLE BIT ABOUT HOW YOU FOUND
YOUR PARTNERS, HOW THAT
RELATIONSHIP GOT STARTED, YOU
KNOW, THAT TENDS TO BE A BARRIER
FOR PEOPLE.
>> IT WAS A BARRIER FOR ME AS I
JUST STARTED MY POSITION IN
TEXAS RIGHT AROUND THE TIME WHEN
THIS GRANT STARTED.
SO I ESSENTIALLY BUILT VERY
QUICKLY, LEVERAGED NETWORKS FROM
COLLEAGUES, FROM THE COLLEGE OF
EDUCATION, HAS LOTS OF TIES INTO
THE SCHOOL DISTRICTS, LEADERSHIP
AT THE STATE LEVEL.
I THINK IT WAS REALLY JUST
LEVERAGING, YOU KNOW, THE
RESOURCES THAT COLLEAGUES HAD,
BUILDING A COMMUNITY VERY
QUICKLY.
I THINK THE CHALLENGE FOR US WAS
TO GET DIVERSITY OF THE
STAKEHOLDERS SO WE WORKED VERY
HARD TO MAKE SURE THAT WE HAD
ESPECIALLY HISTORIC
REPRESENTATIVES, REPRESENTATIVES
FROM SCHOOL SYSTEMS, ALSO AT THE
STATE LEVEL.
>> YOU HAD A NICE MIX THERE.
THE NEXT QUESTION FOR MARY ALT,
IF YOU COULD TALK ABOUT THAT
DIFFERENCE IN YOUR FINDINGS IN
TERMS OF LARGE PERCENTAGE OF
CHILDREN WHO WERE IDENTIFIED AS
HAVING DLD AT A LATER AGE THAN
WHAT HAS TYPICALLY BEEN REPORTED
IN LITERATURE.
WHY DO YOU THINK THERE'S THAT
DISCREPANCY FROM OUR PAST
STUDIES VERSUS THE CURRENT ONE.
>> THE REAL ANSWER IS I DON'T
KNOW.
I'LL TELL YOU WHY I THINK THAT.
I THINK A LOT HAS TO DO WITH
INTEGRITY OF THE TESTS WE USE.
WE INTENTIONALLY CHOSE TESTS
THAT HAVE GOOD PSYCHOMETRICS FOR
DIAGNOSTICS.
AND HISTORICALLY WE HAVEN'T
ALWAYS HAD THOSE AVAILABLE.
THERE HAVE BEEN IMPROVEMENT OVER
TIME WITH THE KINDS OF MEASURES
THAT ARE AVAILABLE TO US.
I ALSO THINK IT'S BECAUSE WE HAD
A SOMEWHAT WIDER RANGE.
ONE OF THE THINGS ABOUT THE
TILLS WE USE, IT LOOKS AT ORAL
LANGUAGE AND WRITTEN LANGUAGE.
I THINK THAT SOME OF THESE
CHILDREN, WHERE THE CHALLENGES
THAT THEY ARE FACING MAY BE MORE
IN, YOU KNOW, DEALING WITH
PHONEMIC THINGS THAT POP UP IN
SPELLING AND READING AND OTHER
COMPONENTS, THAT MIGHT BE
HEIGHTENED THERE.
WE ALSO HAD KIDS WHO WE STARTED,
YOU KNOW, IT WASN'T A
RETROSPECTIVE STUDY SO I THINK
SOMETIMES RETROSPECTIVELY,
THINGS AREN'T -- WE WERE ABLE TO
VERIFY OUR KIDS WERE LATE
TALKERS, THESE ARE SOME REASONS
POPPING UP.
WHEN WE'VE SHARED THIS DATA OR
THESE DATA WITH FOLKS, THE
RESPONSE TYPICALLY IS THAT
RESONATES.
THE CROWD HERE MAY HAVE OTHER
FEELINGS.
BUT I THINK THAT -- I THINK
CLINICALLY A LOT OF TIMES THAT'S
WHAT IT MAY SEEM LIKE TO FOLKS.
IT'S NOT JUST THAT, OH, YEAH,
EVERYONE GETS BETTER.
I THINK IT'S REALLY IMPORTANT TO
BE WATCHING THESE FOLKS AND
MAKING SURE THEY ARE GETTING THE
SUPPORT THEY NEED TO SUCCEED.
BUT I'M CURIOUS TO HEAR IF OTHER
PEOPLE HAVE OTHER IDEAS ABOUT
WHY IT MIGHT BE.
>> THAT'S ALL THE TIME WE HAVE
FOR LIVE QUESTIONS.
IF WE COULD BRING UP THE SLIDE
FOR THE INTRODUCTION TO OUR
PANEL, WE'LL SWITCH GEARS NOW.
IF YOU HAVE QUESTIONS THOUGH FOR
OUR SPEAKERS, FLASH TALK
SPEAKERS, FEEL FREE TO PUT THOE
IN THE Q&A AND THEY WILL ANSWER
AS THEY ARE ABLE TO.
I DON'T WANT TO OVERPROMISE WHAT
WE'RE GOING TO ACCOMPLISH IN
THIS PANEL.
I WANT TO CAREFULLY SAY THIS
PANEL IS GOING TO SCRATCH THE
SURFACE ON THE KNOW-DO GAP OR
RESEARCH TO PRACTICE GAP.
WE CREATE EVIDENCE-BASED
PRACTICES, EBIs OR EBPs BUT
RARELY DO THEY MAKE THEIR WAY
INTO EVERYDAY LIFE, CREATING A
GAP.
WE'RE GOING TO DO OUR BEST TO
GRAPPLE WITH THIS LONGSTANDING
AND COMPLEX PROBLEM AND THINK
THROUGH IF THERE ARE WAYS WE CAN
DO BETTER.
ARE THERE WAYS WE CAN SMOOTH OR
ACCELERATE THIS TRANSITION FROM
RESEARCH TO PRACTICE, AND TRY TO
NARROW OR ELIMINATE THIS KNOW-DO
GAP OR RESEARCH TO PRACTICE GAP.
I INVITE OUR PANELISTS TO TURN
ON CAMERAS AS I INTRODUCE THEM.
MARY ALT WILL JOIN US, DAN
BAGNER FROM FIU, AND KARLA
WASHINGTON FROM UNIVERSITY OF
TORONTO WILL BE JOINING US.
AND NAN BERNSTEIN-RATNER WAS
SUPPOSED TO BE WITH US.
SHE HAD A LAST-MINUTE ISSUE COME
UP AND MAY OR MAY NOT BE ABLE TO
JOIN US AT SOME POINT DURING OUR
DISCUSSION.
THANKS, EVERYONE, FOR BEING HERE
AND FOR BEING FEARLESS AND
TACKLING THIS TOPIC.
WE CAN GO AHEAD AND TAKE THE
SLIDE DOWN NOW SO EVERYONE CAN
SEE OUR PANELISTS BETTER.
KICKING OFF OUR FIRST THEME,
WHICH MARY COINED THE PHRASE IN
OUR PANEL, PREPARATION
DISCUSSION, WALKING THE LINE
BETWEEN CLEAN AND REAL, WHICH I
REALLY LIKE.
WHEN DESIGNING CLINICAL RESEARCH
STUDIES YOU HAVE TO MAKE MANY
CHOICES THAT CREATE THIS YIN AND
YANG BETWEEN RIGOR AND VALIDITY
VERSUS RELEVANCE AND EXTERNAL
VALIDITY.
VIRTUALLY EVERY DESIGN CHOICE
YOU MAKE PUSHES AND PULLS YOU
ALONG THIS DIMENSION.
PARTICIPANTS SELECTION CRITERIA,
BROAD OR NARROW, TREATMENT
PROTOCOL, STANDARD ONE SIZE FITS
ALL OR SOMETHING MORE ADAPTIVE
THAT MIGHT BE MORE LIKE WHAT
SOMEONE WOULD DO IN THE REAL
WORLD.
OUTCOME MEASURES, HAVING VERY
RICH BUT TIME CONSUMING MEASURES
LIKE LANGUAGE SAMPLES, VERSUS
BRIEFER MEASURES THAT ARE
REGULARLY USED IN CLINICAL
PRACTICE.
AND THE LIST GOES ON AND ON.
SO ALL THESE DECISIONS HAVE
CONSEQUENCES FOR THE SCIENCE
RESEARCH SIDE OF THINGS, BUT
ALSO FOR THE FUTURE TRANSLATION
INTO CLINICAL PRACTICE.
IS YOUR DECISION WIDENING OR
NARROWING THE GAP?
THE QUESTION FOR THE PANELIST IS
WHAT DO YOU THINK WHEN YOUR
STRIKE THIS BALANCE BETWEEN
CLEAN AND REAL, HOW DO YOU
NAVIGATE THE WATERS AND GIVE
SOME EXAMPLES OF HOW YOU DO
THIS.
MARY COINED THE PHRASE SO WE'LL
LET HER KICK US OFF.
>> THANK YOU FOR THE CHANCE TO
DO SO.
THIS IS SOMETHING I STRUGGLE
WITH PRETTY MUCH EVERY SECOND OF
EVERY DAY, RIGHT?
BECAUSE THERE REALLY ARE
OPPOSING FORCES.
WE KNOW ON THE RESEARCH SIDE IF
YOU DON'T HAVE YOUR STUDY CLEAN
ENOUGH YOU'RE NOT GOING TO GET
PUBLISHED.
MORE IMPORTANT THAN THAT IF YOU
DON'T CONTROL YOUR VARIABLES,
YOU'RE NOT GOING TO GET GOOD
ANSWERS TO YOUR QUESTIONS.
AND THEN ON THE FLIP SLIDE, IF
YOU ARE NOT TAKING INTO ACCOUNT
WHAT THE COMMUNITY NEEDS, IT
DOESN'T MATTER WHAT YOU DESIGN
IF IT NEVER GETS USED, WHAT'S
THE POINT THERE?
SO YOU'VE GOT THESE POLAR
OPPOSITE TYPES OF FORCES.
AND ONE THING I'M COGNIZANT OF
IS HOW VALUABLE IT IS TO HAVE
INTERESTED PARTIES, PARTNERS IN
RESEARCH AND ON YOUR TEAM.
I REALLY DON'T WANT TO DIVE IN
AND SAY, HERE, TRY THIS, TRY
THAT, AND HAVE PEOPLE DO THINGS
THAT HAVEN'T BEEN TESTED OUT IN
THE LAB THAT I HAVE A SENSE ARE
GOING TO WORK BECAUSE I DON'T
WANT TO BE WASTING THEIR TIME.
AND SO I GUESS -- WE CERTAINLY
HAVE HYBRID DESIGNS BUT STILL IT
STARTS WITH THE IDEA YOU HAVE
SOMETHING YOU HAVE ENOUGH GOOD
EVIDENCE THAT YOU THINK IS NOT
GOING TO WASTE YOUR COMMUNITY
PARTNER'S TIME BECAUSE THAT CAN
REALLY COLLAPSE A RELATIONSHIP.
SO, AS I WAS REFLECTING ON THIS
I RECOGNIZE WE DO A COUPLE OF
THINGS THAT HAVE BEEN -- THAT
ARE A BIT HYBRIDY, MAYBE DON'T
FIT INTO A BEAUTIFUL HYBRID
MODEL.
WHILE OUR STUDY ACTUALLY CAME
ABOUT BECAUSE OF COMMUNITY
NEEDS, I HAD A FRIEND WHO IS AN
SLP WHO HAD A LATE TALKER, I
COULD DO NOTHING TO TEACH HER
ABOUT LANGUAGE NUTRITION AND
TECHNIQUES.
SHE WAS ON IT, A PHENOMENAL SLP,
NO WHERE TO GO IN TERMS OF
PARENT TRAINING.
WHAT APPROACHES COULD WE TAKE?
WHAT'S HAPPENING IN THE FIELD IN
THE RESEARCH QUESTION QUESTION
WAS INSPIRED BY A PERSON.
AND THAT'S IMPORTANT BECAUSE IT
SHAPED HOW THINGS WENT.
THE OTHER THING THAT HAPPENED,
IT WAS JUST YESTERDAY I THOUGHT
ABOUT IT, WE'VE HAD SOME KIDS
WHERE CLINICALLY I COULD SEE AS
WE WERE GOING THROUGH OUR
TREATMENT THEY WERE NOT
RESPONDING.
AND I HAD OTHER IDEAS FOR WHAT I
WANTED TO DO BUT I CONSTRAINED,
USED MY FRONTAL LOBE AND
FINISHED THE TREATMENT THEN AT
THE END WE TACKED ON A PLACE TO
EXPERIMENT MORE, NOT THIS IS
WRITTEN INTO OUR IRB AND WE
SHARED WITH THE PARENTS, BUT
LIKE IN THIS CASE WE BRING IN
SOME AAC, AND YESTERDAY WE HAD
AN AMAZING SESSION WHERE WE WERE
ABLE TO GET A KID WHO WAS A
NON-RESPONDER, BE ABLE TO
EXPERIMENT A LITTLE BIT MORE AND
WE GOT SPOKEN AND AAC OUTPUT.
IT WAS AMAZING.
WE GOT KISSES FROM THE CHILD.
IT WAS A BIG DEAL.
AND THAT INFORMS THE NEXT STEPS.
IN OUR CURRENT GRANT THIS IS NOT
THE FIRST TIME WE'VE DONE THIS
BUT WE HAVE SOMETHING IN OUR
CURRENT PARENT GRANT THAT WILL
ALLOW US TO BRING IN SOME OF
THOSE MODIFICATIONS.
SO, I'M NOT SURE BUT THOSE ARE
SOME OF THE WAYS THAT WE TRY TO
WALK THE LINE.
>> THAT'S REALLY HELPFUL.
WONDERFUL TO HEAR TOO THAT YOU
WERE ABLE TO CAPITALIZE ON SOME
REAL WORLD FEEDBACK AND INPUT OF
WHAT SOMEONE NEEDED OF REAL
WORLD EXPERIENCE.
DAN, DO YOU HAVE THOUGHTS TO
ADD?
OR DIFFERENT DIRECTION?
>> SURE.
YEAH, THAT WAS HELPFUL.
THANKS, MARY.
THE ISSUE I ALSO HAVE BEEN
GRAPPLING WITH MY ENTIRE CAREER,
REFLECTING ON EVEN STARTING
GRADUATE SCHOOL I GRAPPLED WITH
THIS, UNIVERSITY OF FLORIDA, I
STUDIED PARENT-CHILD INTERACTION
THERAPY, EVIDENCE-BASED
TREATMENT, AT THE TIME ALL OF
THE INTERVENTIONS SIMILAR
HELPING THE NON-COMPLIANT CHILD,
INCREDIBLE YEARS, TRIPLE T, THEY
ALL SCREENED OUT CHILDREN WITH
INTELLECTUAL DISABILITIES.
THE REASON WAS TO INCREASE
INTERNAL VALID ACTIVITY STUDIES,
WANTED CLEAN SAMPLES OF CHILDREN
WITH OPPOSITIONAL DEFIANT
DISORDER AND OTHER DISRUPTIVE
BEHAVIOR DISORDERS, SCREENING
OUT CHILDREN WITH LANGUAGE
DELAYS THAT.
STRUCK ME AS A STRONG NEED, A
HUGE GAP IN LITERATURE.
FOR MY DISSERTATION WE ASKED
CHILDREN WITH INTELLECTUAL
DISABILITIES, AND I DON'T THINK
THAT -- THAT BROADENED THE
POPULATION CERTAINLY, INCREASING
INTERNAL VALIDITY IN THAT CASE
AS EXAMPLE NECESSARILY AFFECTED
INTERNAL VALIDITY OF THE STUDY
SO I THINK YOU COULD BE CREATIVE
IN WAYS TO CAPITALIZE ON
DIFFERENT POPULATIONS IN NEED.
OUR CURRENT WORK, WORKING WITH
INFANTS AT RISK FOR DEVELOPING
BEHAVIOR DISORDERS, AGAIN WE'RE
NOT TARGETING LANGUAGE BUT
LANGUAGE HAS BECOME A BIG
INTEREST OF OUR TEAM'S WORK, AND
SO WE'RE CAPITALIZING ON THE
STUDY THAT WE'RE TARGETING THESE
CHILDREN.
AND WE'RE ABLE TO EXAMINE
LANGUAGE AS AN INTERVENTION IS
BEING IMPLEMENTED IN THE REAL
WORLD, TO SEE WHAT HAPPENS AND
TO SO AGAIN WE'RE NOT
NECESSARILY DECREASING OUR
INTERNAL VALIDITY OF THE STUDY.
IT'S A RANDOMIZED CLINICAL
TRIAL, WE'RE ABLE TO LOOK AT
OTHER OUTCOMES LIKE LANGUAGE,
CERTAINLY PERTINENT FOR THIS
POPULATION.
>> DOES ANYONE WANT TO JUMP IN?
KARLA, OR NAN WAS ABLE TO JOIN
US FROM UNIVERSITY OF MARYLAND.
YOU CAME IN LATE SO DON'T FEEL
LIKE YOU NEED TO JUMP IN.
KARLA, ANYTHING YOU WOULD LIKE
TO ADD?
>> THANK YOU BOTH, MARY AND DAN.
I SHARE BOTH POINTS YOU'VE MADE.
I KNOW IN MY OWN WORK THIS WHOLE
IDEA OF CLEAN AND REAL, MY OWN
DISSERTATION HAD A NICE CLEAN
STUDY I THOUGHT WAS WELL
CONSTRUCTED, AND AT THE END OF
THE STUDY WE FOUND THESE RESULTS
BUT WE WERE -- PARENTS WERE
ASKING WHY IS IT MY CHILD DIDN'T
DO AS WELL, AND I HEARD JOHNNY'S
CHILD DID BETTER.
AND I WAS STUCK SITTING THERE
THINKING, OH DEAR, WHAT SHOULD I
SAY TO THESE PARENTS?
I SAID, YOU KNOW, EXCELLENT
QUESTION, I'VE BEEN WONDERING
MYSELF, LED ME TO THINK ABOUT
USING A DIFFERENT TOOL
NEUROIMAGING BECAUSE THEN I WAS
FOLKS FOCUSED ON STANDARDIZED
TEST, LANGUAGE SAMPLING AND
PARENT INTERVIEWS THAT ALLOWED
ME TO GET QUALITATIVE ASPECT
WHAT IS PARENTS WERE THINKING
OVER TIME.
THE CHANGES WEREN'T CAPTURED IN
OTHER WAYS, WEREN'T GETTING THE
WHY ANSWER FROM THE QUANTITATIVE
ASPECTS SO DELVING INTO MIRROR
IMAGING, A MEANS OF ANSWERING A
QUESTION, WE FORGET THE BRAIN IS
STILL A PART OF WHAT'S HAPPENING
HERE, WE STILL NEED TO
UNDERSTAND WHAT'S HAPPENING WITH
THE CHILD'S BRAIN.
SO I FEEL, FOR ME, IT'S BEEN A
MOTIVATING FACTOR BECAUSE THE
GENESIS OF WHY I MOVE IN THAT
DIRECTION WAS OUT OF WHAT
PARENTS WERE ASKING ME SO I
COULD ANSWER A QUESTION THAT
OFFERED MORE COMMUNITY RELEVANCE
BUT USING MORE OF A MEDICAL
ROUTE TO COME TO IT.
SO I JUST WANTED TO ADD THAT TO
THE DIALOGUE.
THANK YOU.
>> ACROSS THE ANSWERS THERE WAS
THOUGHTFULNESS HOW TO REMAIN
FLEXIBLE IN THE ORIGINAL DESIGN.
I LOVE THE IDEA OF HAVING A
PILOT IDEA.
DAN CAPTURING THE LANGUAGE, EVEN
THOUGH THAT WASN'T MAYBE THE
ORIGINAL INTENT, BEING OPEN TO
NOVEL OBSERVATIONS.
KARLA, YOUR THOUGHT HERE ABOUT
HAVING THAT QUALITATIVE DATA
THAT ADDS CONTEXT AROUND THE
THINGS THAT WERE HYPOTHESIS
DRIVEN THAT MEASURING.
COULD YOU TALK ABOUT SOME
PRACTICALITIES OF OPENNESS WITH
AN IRB?
MARY, YOU ALLUDED TO THIS, HOW
YOU PUT IN THE PILOT PIECE WITH
YOUR IRB AND HOW YOU WORKED THIS
IN TO CAPITALIZE ON NOVEL
THINGS.
>> SURE.
EVERY DISCUSSION WITH OUR IRB IS
A NEGOTIATION.
BUT I THINK WE REALLY -- WE JUST
THOUGHT WHAT DO WE WANT TO DO
AND HOW DO WE FRAME IT IN TERMS
OF WHAT WE ALREADY HAVE
PERMISSION FOR.
AND SO OUR TREATMENT WAS -- YOU
KNOW, PARENTS WERE CONSENTING TO
HAVE THEIR CHILD BE PART OF A
TREATMENT.
THE TREATMENT WASN'T OVERLY
SPECIFIED WITHIN THE IRB.
AND WHAT WE WERE GOING TO BE
DOING WASN'T -- YOU KNOW, IN
TERMS OF HUMAN SUBJECTS TYPE OF
THINGS, HARM OR RISK OR WHAT
NOT, EQUALLY RISKY, IF YOU WILL.
WE THOUGHT IT FIT WELL.
WE WANT TO BE CLEAR WE WROTE IN
SOMETHING, I'M LOOKING TO
CECILIA WILL TELL ME IF I'M
WRONG HERE BUT WE BASICALLY SAID
AT THE END -- YOU KNOW,
TREATMENT IS MEANT TO BE 8 WEEKS
WITH FOLLOW-UP.
AT THE END OF THAT YOUR CHILD
MAY BE INVITED FOR AN ADDITIONAL
FOUR SESSIONS OR FOUR TO SIX
SESSIONS, THAT WILL BE A
LITTLE -- I DON'T KNOW EVEN JUST
HOW MUCH DIFFERENT WE PUT IN BUT
WE LET PEOPLE KNOW AT THE OUTSET
THIS COULD HAPPEN, IT'S
COMPLETELY OPTIONAL, AND THEN
WE'RE TRANSPARENT WITH THE
PARENTS ABOUT IT.
SO WE DON'T HAVE TO HAVE A
SEPARATE FORM SIGNED OR
SOMETHING BUT WE PUT THAT IN AS
A MODIFICATION ONCE WE
RECOGNIZED THIS WAS SOMETHING WE
WOULD USE.
WE'VE DONE IT ABOUT I THINK
MAYBE SIX TIMES OVER THE COURSE
OF THINGS BUT IT'S BEEN -- IT'S
WORLD REALLY WELL WHICH I CAN'T
ALWAYS SAY FOR THE IRB.
>> I COULD JUMP IN HERE TOO
BRIEFLY.
SO, WHEN WE RECEIVED THE
SUPPLEMENT WE KIND OF I THINK
DID A HYBRID APPROACH WHERE SOME
OF THE DATA WE ALREADY HAVE
ACCESS TO, ALREADY OBSERVING
KIDS PLAYING WITH OTHER CHILDREN
IN ENVIRONMENTS TO CAPITALIZE
AND MEASURE THAT.
FORTUNATELY WITH NIH'S
GENEROSITY WE WERE ABLE TO
PURCHASE A LOT OF LENA DEVICES
TO ACTUALLY MEASURE CHILD
LANGUAGE IN A DIFFERENT CONTEXT
IN THE MORE NATURAL ENVIRONMENT.
SO FOR THAT OBVIOUSLY WE NEEDED
TO GET ADDITIONAL PERMISSION
FROM FAMILY, SO WE APPROACHED
FAMILIES, WE HAVE A NEW PART TO
THE STUDY, INTERESTED IN
EXAMINING LANGUAGE IN THIS
DIFFERENT WAY.
AND, YOU KNOW, EXPLAINING TO THE
IRB CERTAINLY THAT IT'S NOT MUCH
MORE OF A BURDEN FOR FAMILIES,
AN IMPORTANT THING THEY WANT TO
KNOW, AND WE DO PROVIDE
INCENTIVES FOR FAMILIES TO
PARTICIPATE IN THAT ADDITIONAL
PIECE OF THE STUDY.
THAT'S HOW WE NAVIGATED WITH
THIS TYPE OF APPROACH.
>> GO AHEAD, NAN.
>> SO AT MARYLAND, I'VE BEEN
INTERESTED IN PARENT-CHILD
INTERACTION FOR A LONG TIME.
WE HAVE PERMISSION FROM OUR IRB
TO PHRASE THAT WE'RE STUDYING
CHILD LANGUAGE DEVELOPMENT AND
HAVE THE USUAL IRB PERMISSIONS
SET UP, IN A VAGUE WAY BECAUSE
WE LOOK AT NATURALISTIC
INTERACTIONS PRETTY MUCH.
THEN WE -- ACTUALLY AT THE END
OF THE STUDY WE HAVE A SEPARATE
CONSENT FORM IN WHICH WE
DISCLOSE THAT WE'RE ALSO
INTERESTED IN THE PARENTS SPEECH
AND ASK PARENTS TO RE-SIGN A
DIFFERENT CONSENT FORM THAT
INCLUDE THEIR DATA.
WE HAVE ACTUALLY NEVER HAD A
PARENT REFUSE.
I'VE BEEN WORKING AT MARYLAND
FOR 40 YEARS, WE'VE NEVER HAD A
PARENT REFUSE.
IT IS CONSIDERED OKAY, WE DON'T
HAVE LENAs, WE BRING THEM IN,
WE DON'T WANT THE PARENTS TO
FEEL LIKE THEY ARE BEING MORE
OBSERVED THAN THEY ALREADY ARE.
SO BASICALLY WE -- THAT'S ONE
APPROACH TO TRY AND GET
NATURALISTIC INTERACTION IS TO
PHRASE THE NATURE OF THE STUDY
MORE IN TERMS OF LEARNING ABOUT
THE CHILD'S DEVELOPMENT WHICH OF
COURSE IS WHAT WE ARE INTERESTED
IN DOING BUT THEN COMING BACK
LATER TO GET THE PARENTS'
PERMISSION TO EXAMINE THEIR DATA
IN PARTICULAR WAYS.
>> THANKS FOR THOSE INSIGHTS.
WE LEARNED A LOT ABOUT THE
PRACTICALITIES OF WORKING WITH
YOUR IRB TO BE OPEN TO THESE NEW
INSIGHTS AND I APPRECIATE THAT
COMMENT, MARY, THAT EVERY
CONVERSATION IS A NEGOTIATION.
WE'RE GOING TO TRANSITION TO A
DIFFERENT TOPIC ON OUTCOME
MEASURES.
NAN, THERE'S A QUESTION IN THE
Q&A THAT YOU MIGHT WANT TO READ
OUT A LITTLE BIT AND WE'LL SEE
IF WE CAN INCORPORATE THAT IN
THIS DISCUSSION.
SO TO SET THE STAGE, IT'S TRICKY
MEASURING LANGUAGE, REALLY
ANYTHING IN YOUNG CHILDREN, HERE
I'M THINKING THAT BIRTH TO 3
AGE.
THESE KIDS ARE JUST NOT ALL THAT
USEFUL.
THEY DON'T COOPERATE.
YOU KNOW, THEY DON'T DO THINGS
ON DEMAND.
BEHAVIOR CAN BE UNPREDICTABLE.
DAN CAN TELL US ALL ABOUT THIS.
LIKEWISE SINCE WE'RE INTERESTED
IN THESE LANGUAGE TRAJECTORIES,
YOU KNOW, IT'S A MOVING TARGET,
WHAT WE WANT TO MEASURE OVER
TIME.
REALLY WHETHER IT'S LANGUAGE OR
SOMETHING ELSE.
THINGS ARE CHANGING OVER THE
COURSE OF OUR MEASUREMENT
PERIOD.
SO, WE STILL HAVE THE CHALLENGES
WE WERE JUST TALKING ABOUT,
THINKING ABOUT THE
PSYCHOMETRICS, AND INTERNAL
VALIDITY OF OUR RESEARCH
MEASURES, PRACTICAL
CONSIDERATIONS, OTHER PRACTICALK
CONSIDERATION RELATED TO
INVESTMENT PARTIES, WHAT
OUTCOMES DO PARENTS, EDUCATORS,
POLICYMAKERS INTERESTED IN, SO
WHAT ARE YOUR THOUGHTS ABOUT
MEASURES, YOUR GO-TO MEASURES
SOLID IN SOME AREAS, WHAT ARE
YOUR THOUGHTS WHERE WE CAN USE
FURTHER DEVELOPMENT?
I'LL TURN TO KARLA TO PARTICULAR
US OFF.
>> THANK YOU, HOLLY.
YEAH, AREA OF OUTCOME MEASURES,
I'VE BEEN DOING FOR A WHILE.
MY POSTDOC FOCUS MY TRAINING IN
OUTCOMES MEASUREMENT RESEARCH,
AND IN FULL DISCLOSURE ONE OF
THE TOOLS I'VE USED AS PART OF
MY POSTDOC IS CALLED THE FOCUS
ON THE OUTCOMES OF COMMUNICATION
UNDER SIX.
FOR ME, HOLLY, WHAT YOU WERE
SAYING ABOUT THE MEANINGFULNESS,
THAT'S WHY I FOCUSED ON
FUNCTIONAL ASPECT OF
COMMUNICATION BECAUSE WHILE A
CHILD MIGHT NOT USE LARGE NUMBER
OF WORDS AND COMPLEX WORDS, ARE
THEY ABLE TO BE FUNCTIONAL, AND
I FEEL THAT WHEN WE HAVE A
STARTING POINT WITH TALKING TO A
PARENT, QUESTIONS ABOUT THEIR
CHILDREN, THEY CAN GIVE YOU
SOMETHING POSITIVE, A YES, BUT
NOT AS MUCH, IT'S A BETTER
STARTING POINT THAN HEARING A
SERIES OF NOs, NOs, THEY
CAN'T, THEY CAN'T, SO IT SETS UP
THE CONVERSATION, PARTNERSHIP
WITH THE PARENT TO LEARN MORE
ABOUT THEIR CHILD.
A TOOL LIKE THAT PUTS THE PARENT
IN THE DRIVER'S SEAT BECAUSE
WE'RE SAYING RIGHT AWAY WE'RE
GOING TO LEARN FROM YOU ABOUT
YOUR CHILD BECAUSE WHAT I SEE IS
ONLY ONE POINT IN TIME, WHAT YOU
SEE IS ACROSS TIME.
SO MEASURES THAT ALLOW ME TO
GIVE PARENTS AN OPPORTUNITY TO
TALK ABOUT THEIR CHILDREN, SO
THAT FUNCTIONAL COMMUNICATION
WILL THINK ABOUT THE CHILD IN
CONTEXT OF THE ENVIRONMENT,
COMMUNICATING IN DIFFERENT WAYS,
WITH DIFFERENT PEOPLE, BENEFIT
OF A TOOL LIKE THE THE FOCUS IY
HAVE PROFILE SECTIONS ON IT SO
YOU CAN LOOK AT PLAY, LANGUAGE,
SOCIAL.
AND YOU CAN GET A GARNERING,
WHAT ARE THE STRENGTH AREAS, AND
SO SPEECH LANGUAGE PATHOLOGISTS
CAN WALK THROUGH WITH A PART.
THE FOCUS TOOL, THE CLINICIAN
CAN USE THE TOOL AT THE SAME
TIME AS THE PARENT SO YOU GET
UNDERSTANDING FROM PARENT AND
CLINICIAN ABOUT THAT CHILD'S
PERSPECTIVE.
SO THAT'S BEEN A GO-TO OF MINE
FOR I'D SAY THE LAST DECADE,
FINDING INFORMATION THROUGH THE
TOOL, NOT ONLY MONOLINGUAL
SPEAKERS BUT USING THAT TOOL
EVEN THOUGH INITIALLY DEVELOPED
FOR MONOLINGUAL SPEAKERS OF
ENGLISH, THERE'S A FRENCH
VERSION, WE'VE USED IT IN THE
JAMAICAN CONTEXT, FOR EXAMPLE,
ALSO TRANSLATED INTO A NUMBER OF
OTHER LANGUAGES THAT CAN MAKE
THAT INSIGHT MORE ACROSS
DIFFERENT -- REPRESENTATIVENESS
OF HOW CHILDREN USE LANGUAGE IN
DIFFERENT LANGUAGES, NOT JUST IN
ONE LANGUAGE ONLY.
I'LL TURN THINGS OVER TO MY
COLLEAGUES.
>> OKAY.
MARY, WHAT THOUGHTS DO YOU HAVE?
>> SO MANY.
I THINK A LOT -- I FEEL LOT A
LOT OF TOPICS ARE INTERRELATED.
WHO IS YOUR AUDIENCE, RIGHT? IF
YOU'RE GOING TO, AGAIN, TRY FOR
PUBLICATION OR THINGS LIKE THAT,
PEOPLE EXPECT CERTAIN TYPES OF
MEASURES, HOW CLEANLY DO THEY
THEY ANSWER THE QUESTION, HOW
WELL DOES IT MATCH, AND THESE
ARE IMPORTANT THINGS TO ANSWER
CERTAIN SCIENTIFIC QUESTIONS.
AND THEN THERE ARE THE THINGS,
YOU KNOW, ONE THING I'VE SEEN
SOMETIMES IS WITH OUR STUDY,
THERE WILL BE A MISMATCH BETWEEN
WHAT WE THINK AND WHAT THE
FAMILY FEELS.
WHY IS THAT THERE?
WHAT ARE THEY LOOKING AT?
HOW ARE WE COMMUNICATING ABOUT
WHAT WE'RE FINDING THAT WE THINK
IS GREAT OR WHAT ARE THEY
FINDING THAT'S SO GREAT ABOUT
WHAT WE HAVEN'T BEEN ABLE TO
MEASURE, OR THINGS THAT SEEM
LIKE THEY SHOULD WORK.
SO FOR EXAMPLE ONE OF THE THINGS
WE DO WITH OUR TODDLERS IS A
PROBE TO SEE IF THEY WILL, YOU
KNOW, SAY THE WORD, THEY NEVER
DO THAT.
LIKE IT IS NOT A TODDLER
BEHAVIOR WITH THE TODDLERS THAT
WE WORK WITH.
THEY WILL SAY IT BEFORE, THEY
WILL SAY IT AFTER.
THEY WILL SAY IT AT HOME.
ASK THEM IN A PROBE.
NOT DOING IT.
THAT SEEMS LIKE A GREAT MEASURE
IN A GRANT OR SOMETHING BUT IF
YOU'VE EVER WORKED WITH A
TODDLER IT'S NOT A GOOD ONE.
SO I THINK JUST COMING UP WITH
THOSE THINGS.
I WAS INSPIRED AT THE LAST --
FOR THOSE ABLE TO GO, I THINK
DR. CHRISTY JOHNSON, DOING
AMAZING THINGS WITH CAMERAS AND
FINDING REALLY GREAT WAYS TO
MEASURE OTHER TIMES OF BEHAVIORS
A LITTLE BIT LESS, YOU KNOW,
CHECK-MARKABLE, IF YOU WILL, SO
I'M REALLY LOOKING FORWARD TO
SEEING WHAT OTHER PEOPLE IN THE
AREA ARE DOING WITH THAT
BECAUSE, AGAIN, A LOT IS THE
PURPOSE.
SOMETIMES WHAT THE PARENT LOVED
WAS, WOW, MY CHILD IS
INTERACTING WITH OTHER PEOPLE SO
WELL, NEW CLINICIANS HERE,
FRIENDLY TO THE KIDS IN THE
PLAYGROUND, THIS AND THAT.
THAT WASN'T PART OF THE MEASURE
BUT IS IT VALUABLE?
HECK YES.
BUT THAT WASN'T OUR RESEARCH
QUESTION SO WE CAN'T REPORT IT
THERE.
SO THINKING ABOUT LIKE THERE'S
SO MANY THINGS TO MEASURE, WHICH
DO YOU DO?
BUT I THINK A LOT COMES DOWN TO
WHO IS THE AUDIENCE YOU'RE
TRYING TO COMMUNICATE WITH.
>> GREAT.
NAN, WE'LL TURN TO YOU.
ALSO MAYBE IF YOU CAN
INCORPORATE SOME OF THE COMMENTS
THAT YOU TYPED TO OUR QUESTIONER
OUT THERE.
>> GREAT.
>> THAT FALLS IN HERE.
>> MY PARENT GRANT, EVEN PART OF
THE SUPPLEMENT WE'RE FOCUSED ON
GRAMMATICAL DEVELOPMENT.
I'M VERY MUCH A FAN OF THE
FUNCTIONAL MEASURES BUT WE WERE
DEALING WITH KIDS WHO BASICALLY
WERE NOT SOCIALLY AT RISK BUT
REALLY WERE HAVING PROBLEMS
LEARNING GRAMMAR.
AND SO ONE OF THE THINGS THAT WE
HAVE BEEN CONCERNED ABOUT
MEASURES THAT WE TEND TO USE.
TO MAKE A LONG STORY SHORT,
WE'RE KIND OF AT THE POINT WE
FEEL LANGUAGE SAMPLE ANALYSIS
WHICH ALL OF US HAVE TRIED TO
USE AT ONE POINT OR ANOTHER
NEEDS TO BE DIVIDED INTO TWO
DIFFERENT GOALS, MAYBE.
ONE IS TO SEE WHETHER OR NOT THE
LANGUAGE SAMPLE CAN HELP AUGMENT
IDENTIFICATION.
WHICH A LOT OF PEOPLE HAVE
THOUGHT LANGUAGE SAMPLE MEASURES
CAN BUT I'M HERE TO TELL YOU
ONLY ONE SEEMS TO WORK RIGHT
NOW.
AND THEN HOW TO GUIDE
REMEDIATION.
IN OTHER WORDS, HOW TO TELL THE
THERAPIST WHAT SORTS OF THINGS
MIGHT BE USEFUL TO WORK ON.
SO WHAT WE FOUND IN A NUTSHELL
IS THAT MLU IS VERY GOOD AT
DISCRIMINATING GROWTH IN TIME,
GROWTH ACROSS TIME IN CHILDREN,
DISCRIMINATING TYPICAL FROM
ATYPICAL LEARNERS.
IT'S NOT VERY HELP FOLLOW A
THERAPIST.
AND SO WHAT WE HAVE FOUND AT THE
SAME TIME USING
COMPUTER-ASSISTED ANALYSIS
THINGS LIKE DEVELOPMENTAL
SENTENCE SCORING, INDEX OF
PRODUCTIVE SYNTAX ARE NOT
FABULOUS WITH PSYCHOMETRIC
PROPERTIES BUT GIVE A LOT TO
WORK ABOUT.
WHAT ABOUT KIDS WHO SPEAK A
DIFFERENT VERSION OF ENGLISH,
WAS THE QUESTION IN THE CHAT?
WE RELEASED BLACK ENGLISH
SENTENCE SCORING WHICH WE DID
NOT DEVELOP BUT HAVE COMPUTER
AUGMENTED SO YOU CAN ASSESS
CHILDREN WHOSE VERSION OF
ENGLISH MIGHT BE, SAY, AFRICAN
AMERICAN ENGLISH, OR OTHER
VERSIONS, TRYING TO SHIFT THE
POINTING TO THINGS COMMON ACROSS
DIALECTS OF ENGLISH AND NOT
DISCRIMINATING.
THE OTHER QUESTION IN THE CHAT,
COMPLICATED QUESTION, FROM VAL
WHO I HAVEN'T SEEN IN A WHILE,
WHAT DO WE DO ABOUT USING ASR TO
MAKE LANGUAGE SAMPLE ANALYSIS
BETTER.
ASR IS GETTING BETTER BUT FOR
KIDS AND PARTICULARLY KIDS WHO
ARE ALSO PHONEOLOGICALLY NOT
WHERE THEY NEED TO BE, AND MY
KIDS STUTTERING, YOU ALMOST HAVE
TO DO SO MUCH HAND TOOLING, HAND
CORRECTION AFTERWARDS, THAT IT'S
NOT THERE.
HOWEVER, IT'S GETTING BETTER
WITH EACH AND EVERY DAY.
SO WE'RE HOPING IN THE NEXT FEW
YEARS THAT WILL TAKE A LOT OF
BURDEN OUT OF LANGUAGE SAMPLE
ANNUAL SILLS TOO -- ANALYSIS
TOO.
>> I'D LIKE TO PUSH US IN A
DIFFERENT DIRECTION.
WE'RE WILL A LITTLE BIT,
THINKING ABOUT TECHNOLOGY.
MARY HAD MENTIONED ONE OF THE
TALKS FROM LAST WEEK, NOVEL
APPROACHES, AND WE HAD SOME GOOD
DISCUSSION LAST TIME ABOUT
MACHINE LEARNING APPROACHES, AND
NAN WAS TALKING ABOUT THE
AUTOMATIC SPEECH RECOGNITION,
SOME OF THE TOOLS THAT SHE'S
CREATED FOR LANGUAGE SAMPLE
ANALYSIS.
I'D LIKE TO OPEN UP TO THIS
GROUP, ARE THERE OTHER THINGS ON
THE HORIZON THAT YOU WOULD HOPE
THAT WE WOULD TAKE ADVANTAGE OF
OR YOU COULD ALSO ENDORSE ANY OF
THE THINGS THAT I'VE JUST NAMED
AS LIKE WE NEED TO BE LOOKING AT
THAT, SO DAN, YOU HAVE A FINGER
UP, WHAT DO YOU THINK?
>> I THINK MULTI-METHOD APPROACH
IS OF COURSE ADEAL.
AND OUR GROUP HAS JUST STARTED
TO EXPLORE THIS POSSIBILITY.
MORE RELATED TO MOST OF OUR WORK
FOCUSED ON INTERVENTION PIECE
AND TEACHING PARENTS TO SAY
DIFFERENT THINGS TO THEIR CHILD,
AND REINFORCE BEHAVIORS, A LOT
OF WHAT WE DO IS CODE THE SPEECH
FROM THE PARENT, THINGS THE
PARENT SAYS TO THE CHILD.
WE JUST PARTNERED WITH A
COLLEAGUE, TWO COLLEAGUES IN
COMPUTER AND ELECTRICAL
ENGINEERING, THEY HAVE DONE
PILOT WORK SEPARATE FROM OUR
TEAM WHERE THEY USED THINGS LIKE
ChatGPT, IT'S OUT OF MY AREA,
TO CODE THE PARENTS' LANGUAGE,
AND COMPARING IT TO HOW WE CODE
IT AS HUMANS.
SO THEY JUST -- WE SUBMITTED A
GRANT TO DO THAT IN MORE DETAIL,
FOCUS ON THE PARENT LANGUAGE BUT
THERE ARE REALLY BIG
IMPLICATIONS FOR POTENTIALLY
DOING THIS FOR CHILD LANGUAGE,
AND IF WE'RE ABLE TO DO IT
SUCCESSFULLY, COULD PROVIDE AN
OPPORTUNITY TO GIVE REALTIME
FEEDBACK TO THERAPISTS, PARENTS,
AS THEY ARE WORKING WITH
CHILDREN.
THERE'S HUGE POTENTIAL.
OBVIOUSLY A LOT OF WORK NEEDS TO
BE DONE.
I THINK RELATES TO OUR NEXT
TOPIC QUESTION, FORESHADOW WHO
WE NEED TO INVOLVE, WHAT EXPERTS
WE NEED, IN THE AREA OF
ENGINEERING AND UNDERSTANDING
ARTIFICIAL INTELLIGENCE.
>> GREAT.
ANYONE HAVE OTHER THOUGHTS?
GO AHEAD, NAN.
>> JUST REAL FAST.
I REALLY STILL AM A GREAT FAN OF
LANGUAGE SAMPLE ANALYSIS, BOTH
FUNCTIONAL AND STRUCTURAL LEVEL.
AND I DO THINK THAT WE'VE MADE A
LOT OF PROGRESS IN MAKING IT A
MORE -- A MORE EASY TO
ACCOMPLISH AND LESS TIME
CONSUMING PROCESS.
IT YIELDS A LOT OF RICHNESS WHEN
YOU CAN DO IT.
PART OF WHAT WE NEED TO GET
OVER, UNFORTUNATELY, BECAUSE
WE'RE ALL SORT OF TALKING TO ONE
ANOTHER HERE IS THAT EVERY TIME
WE GO OUT AND SURVEY PEOPLE,
THEY DON'T WANT TO DO EVEN LOW
TECH LANGUAGE SAMPLE ANNUAL IS.
- ANALYSIS, THE THAT THING THEY
HATE MORE, PEOPLE ENTER OUR
FIELD TO GET AWAY FROM
TECHNOLOGY SO IT'S GOING TO BE I
THINK A HARD SELL TO GET
EVERYDAY CLINICIANS TO DO MANY
OF THESE THINGS.
AND IT IS DISTURBING IN SOME
RESPECTS TO ME AS A CLINICIAN
THAT WHEN WE HAVE CLINICIAN WHO
IS ACTUALLY DO STUFF, I'M GOING
TO ANSWER A QUESTION RIGHT NOW,
WHEN WE DO STUFF LIKE TAKE A
LANGUAGE SAMPLE, ALL WE KNOW
FROM STUDIES ARE CLINICIANS ARE
GETTING ONLY MLU, THAT IS THE
MEASURE THEY ARE GETTING.
MLU IS A VERY GOOD DIAGNOSTIC
MEASURE BEWE'RE NOT ADDING TO
DIAGNOSTIC SPECIFICITY IF YOU'RE
GIVING OTHER TESTS.
WE NEED TO KNOW HOW TO THEN THE
CHILD, MLU IS FABULOUS BUT
DOESN'T HELP A CLINICIAN DECIDE
HOW TO HELP A CHILD.
>> WONDERFUL.
THANKS FOR THOSE THOUGHTS.
THERE'S ONE QUESTION IN THE Q&A
THAT MAYBE WE CAN DEAL WITH
QUICKLY BEFORE WE MOVE TO
ANOTHER TOPIC.
HAS ANYONE HAD EXPERIENCE USING
THE COMMUNICATION MATRIX?
DO ANY OF YOU ON THE PANEL HAVE
EXPERIENCE WITH THAT?
NOT SEEING ANYONE.
OKAY F ANY --
>> I IMMEDIATELY LOOKED IT UP ON
MY CELL PHONE AND WILL LOOK AT
IT LATER.
>> SORRY WE CAN'T ADD INSIGHTS
ON THAT.
WE'LL MOVE TO OUR THIRD TOPIC,
WHICH IS ABOUT EXPERTS, DAN
FORESHADOWED THAT.
INNOVATION DEVELOPMENT,
TREATMENT AND ASSESSMENT
DEVELOPMENT, IS CONDUCTED BY
TEAMS.
HOW DO WE FOCUS TOWARDS THE
RESEARCH EXPERTISE NEEDED FOR
DEVELOPMENT AND EVALUATION, YOU
MIGHT HAVE PSYCHOMETRICIAN,
DOING INTERVENTION YOU MIGHT
HAVE CLINICAL TRIAL SPECIALIST
WITH THE USUAL LANGUAGE AND
COMMUNICATION DISORDER EXPERTS.
BUT IF OUR GOAL IS TO IMPACT
LIVES OF INDIVIDUALS WITH
LANGUAGE AND COMMUNICATION
STRUGGLES, THERE ARE OTHER
PEOPLE WHO HAVE PIECES TO THIS
PUZZLE.
SO AS WE ARE TALKING EARLIER,
WHAT MAKES THE DIFFERENCE FOR A
PARENT OR CAREGIVER, WHAT DO
THEY WANT FOR THEIR CHILD, WHAT
PROBLEMS DO TEACHERS OR SLPs
NEED SOLVED?
SO WHAT ARE YOUR THOUGHTS ABOUT
WHAT EXPERTISE IS NEEDED, AT
WHAT POINT DURING THIS KIND OF
DEVELOPMENTAL AND RESEARCH
PROCESS?
AND HOW DO YOU GO ABOUT
INVOLVING PEOPLE WITH EXPERTISE?
SO, DAN, CAN YOU START US OFF
SINCE YOU YOU ALLUDED TO THIS .
>> SURE.
I THINK AS YOU SAID WE ALL
START -- WE ALL NEED
COLLABORATIVE TEAMS.
I'M A CLINICAL CHILD
PSYCHOLOGIST, MY EXPERT IS NOT
IN LANGUAGE.
THE WORK I'VE BEEN PURSUING AS
PART OF THE TALK INITIATIVE I'M
WORKING CLOSELY WITH MY
COLLEAGUE DR. MELISSA BERALT ON
THE CALL.
SO SHE STUDIES -- PARTICULARLY
OUR WORK IS DONE IN MIAMI WHERE
MANY OF OUR FAMILIES ARE ALSO
BILINGUAL, ENGLISH AND SPANISH,
I RELY HEAVILY ON HER EXPERTISE
AS AN EXPERT IN BILINGUAL
DEVELOPMENT, SHE'S WORKED WITH A
LOT OF COMMUNITY STAKEHOLDERS
THAT HELP INFORM HER WORK AND
INFORM OUR COLLABORATIVE WORK
TOGETHER.
CERTAINLY THE EXPERTISE NEEDS TO
BE COLLABORATED BUT AS YOU
ALLUDED TO AS WELL, HOLLY, THAT
FAMILIES AND ALSO PROVIDERS'
INPUT IS ESSENTIAL.
SO, IN OUR WORK WE STARTED TO DO
PILOT WORK, WAITING ON FUNDING
FOR HOPEFULLY OTHER WORK WITH
EARLY INTERVENTION, WORKING WITH
PROVIDERS WHO DEAL WITH, YOU
KNOW, THEY PRIMARILY SEE KIDS
WITH LANGUAGE, THE MOST COMMON
REFERRAL TO EARLY INTERVENTION,
WORKING CLOSELY, FINDING OUT
WHAT THEIR NEEDS ARE, HOW WE CAN
HELP EVIDENCE-BASED PRACTICES WE
KNOW FROM OUR RESEARCH, HOW TO
GET INTO THAT THEIR EVERYDAY
WORK.
I THINK THAT'S CRITICAL.
IN TERMS OF -- CERTAINLY THE
FAMILY PIECE AS WELL, BRINGING
FAMILIES INTO THE CONVERSATION,
ARE WE IMPACTING ON THINGS
IMPORTANT FOR THEM AND THEIR
KIDS AND THEIR NEEDS.
IN TERMS OF THE QUESTION ABOUT
TIMING, AT ALL STAGES IT'S
IMPORTANT.
I THINK WE TEND TO FOCUS ON THE
INTERVENTION DEVELOPMENT STAGE
AND WE NEED ALL THESE
STAKEHOLDERS, DEVELOP OUR
INTERVENTIONS, WE'LL JUST TEST
IT AND A LOT OF TIMES FORGET
THOSE IMPORTANT KEY
STAKEHOLDERS, PROVIDERS AND
PARENTS, AT LATER STAGES.
SO WHILE WE'RE ONGOING
CONDUCTING TRIALS, GETTING
ONGOING FEEDBACK, WHEN WE HAVE
RESULTS, SHARING OUR RESULTS, I
THINK IT'S REALLY IMPORTANT TO
GET THAT INFORMATION AT ALL
STAGES AND HAVE THAT
COLLABORATION WITH PROVIDERS AND
FAMILIES AT ALL STAGES OF
INTERVENTION TEST, I'LL LEAVE IT
AT THAT AND SEE WHAT MY
COLLEAGUES THINK.
>> KARLA, WHAT WOULD YOU LIKE TO
ADD?
>> YES.
THANK YOU, I AGREE WITH DAN, A
LOT OF WHAT HE WAS SAYING IS
FRAMED IN A COMMUNITY-BASED
PARTICIPATORY RESEARCH FRAMEWORK
SO THE IDEA OF THESE
STAKEHOLDERS, PEOPLE THINK WHY
DO YOU SAY STAKEHOLDERS, PEOPLE
WITH A STAKE IN THE MATTER, TO
UNDERSTAND AT INCEPTION RATHER
THAN DO THIS HINDSIGHT, 20/20 IS
PERFECT VISION BUT SOMETIMES
TIME IS LOST BECAUSE IT WASN'T
IN A WAY PARTNER INFORMED.
I DIDN'T EVEN REALIZE I WAS
DOING COMMUNITY-BASED
PARTICIPATORY RESEARCH UNTIL I
LEARNED ABOUT IT.
OH, I AM DOING THAT, ISN'T THAT
WONDERFUL?
OH, I SEE, YES, SO BEING ABLE TO
ANSWER QUESTIONS AND UNDERSTAND
TERMINOLOGY AND KEY AREAS OF
FOCUS WITHIN THE COMMUNITY, SO
AS AN EXAMPLE IF YOU THINK ABOUT
AUTOMATIC SPEECH RECOGNITION,
HOW PEOPLE SAY DIFFERENT THINGS
MAYBE ACROSS DIALECTS, SOME MORE
ACCEPTED THAN OTHERS.
MOW THE LAWN, CUT THE GRASS, NO
ONE IS GOING TO SAY THAT'S
INACCURATE.
IN OTHER COMMUNITIES YOU MIGHT
PRESENT THE SAME SEMANTIC
NETWORK CONCERT IN A DIFFERENT
WAY BUT NOT WHAT'S ACCEPTED, NOT
AS FREQUENTLY USED.
SPEECH RECOGNITION, THERE MIGHT
BE THIS JUDGMENT OF INACCURATE
BECAUSE IT'S UNACCEPTABLE, IT'S
LESS KNOWN.
SO TRAINING THE TOOLS, FOR
MYSELF I REMEMBER WHEN AUTOMATIC
SPEECH RECOLLECT NATION CAME UP
WITH BLACKBERRY, REMEMBER THE
CANADIAN, MAYBE IT WAS MY
JAMAICAN ACCENT.
HOWEVER, THE APPLE DEVICE WOULD
DO IT WELL.
IN FACT, STARTED TO KNOW HOW TO
SAY WORDS IN CREOLE BUT TYPE IT
OUT IN AN ENGLISH WAY WHEN
COMMUNICATING WITH FRIENDS AND
COLLEAGUES.
POINT BEING WHEN WE WORK WITH
THESE TOOLS WE'RE GOING TO NEED
PARTNERS TO HELP US GIVE MORE
LEGITIMACY TO WHAT WE'RE DOING.
SO WORK YOU'VE DOING, YOU CAN
WORK WITH LANGUAGE PLANNING
AGENCIES, PEOPLE IN ARTIFICIAL
INTELLIGENCE, TEACHERS, PARENTS,
TO UNDERSTAND RELEVANCY AND CAN
PROFFER THE WORK WHEN WE'RE
GONE.
SO THE LONGEVITY OF ANYTHING
THAT WE DO HAS TO BE FRAMED
WITHIN THAT MORE OF A
PARTNERSHIP MODEL.
THAT'S JUST MY TAKE.
>> GO AHEAD, NAN.
>> ONE OF THE GROUPS OF
STAKEHOLDERS IN THE WORK WE'RE
DOING WITH PEOPLE WHO THE
COMMUNITIES AND SLPs, SERVING
THE COMMUNITIES WHO DON'T SPEAK
MAINSTREAM AMERICAN ENGLISH OR
OTHER LANGUAGE COMMUNITIES, WE
ALWAYS HAVE MORE AND LESS
PREFERRED VERSIONS OF THE
LANGUAGE.
YES, SO THE QUESTION WAS -- I
PICKED THE WRONG OPTION, IF I
EVER PRESENTED THE STUFF, YES, I
HAVE.
I HOPE TO KEEP PRESENTING BUT I
DON'T GO EVERY YEAR.
ONE THING WE'VE BEEN CONCERNED
ABOUT, WE'VE ALL BEEN CHOSEN IN
THIS PARTICULAR WORKSHOP BECAUSE
OF THE FOCUS ON EARLY CHILD
LANGUAGE BUT WE'VE BECOME VERY,
VERY FOCUSED ON WHAT HAPPENS
WITH THE CHILDREN WHEN THEY
ENTER SCHOOL, DEALING CAN
TEACHERS, READING AND WRITING
SPECIALISTS.
AS SOON AS THE CHILDREN GET GOOD
ENOUGH IN LANGUAGE AND OLD
ENOUGH THEY ARE GOING TO GO TO
SCHOOL.
AT THAT POINT THEY ARE NOT
JUDGED BY ORAL LANGUAGE AS MUCH
AS BY WRITTEN LANGUAGE.
SO I THINK THAT'S A GROUP AND
SET OF STAKEHOLDERS WE REALLY
DON'T THINK ABOUT TOO MUCH, AS
THESE CHILDREN GROW AND IMPROVE
IN ABILITY, THEY ARE GOING HIT A
NEW WALL WHICH IS HOW DO YOU USE
THE LANGUAGE IN THE WRITTEN
FORMAT, MANY OF OUR STUDENTS.
WE HAVE A LOT OF STAKEHOLDERS
THERE THAT WE ONLY HAVE BEGUN TO
APPRECIATE BECAUSE DEALING WITH
SCHOOLS, AS SOMEBODY ONCE TOLD
ME IN MARYLAND, DON'T WORK WITH
A LOCAL COUNTY, I WON'T NAME IT,
BECAUSE THEIR APPLICATION IS
TOUGHER THAN NIH'S.
TURNS OUT THAT'S ACTUALLY TRUE.
>> GO AHEAD, MARY.
>> I REALLY APPRECIATE
EVERYTHING MY COLLEAGUES HAVE
SAID.
A COUPLE THINGS I'LL ADD IS THAT
AS WE TALK ABOUT OLDER CHILDREN,
THEY ARE ONE OF THE MAIN
INTERESTED PARTIES, RIGHT?
I THINK IT'S IMPORTANT TO HEAR
FROM THE PEOPLE THEMSELVES, OF
COURSE.
AND THE OTHER THING I JUST --
I'M SO APPRECIATIVE OF THE
EFFORTS THAT ARE BEING MADE TO
TAKE THIS KIND OF WORK AND FUND
IT, PUBLISH IT, SO NIH
INITIATIVES FOR IMPLEMENTATION
SCIENCE, THIS WORK IS TIME
CONSUMING, DOESN'T FOLLOW A NICE
TRAJECTORY A LOT OF TIMES.
IT'S ABOUT PEOPLE.
IT'S ABOUT RELATIONSHIPS.
IT'S ABOUT BUILDING TRUST.
AND SO I'M REALLY EXCITED THAT
THERE ARE NEW MECHANISMS OUT
THERE.
IT REALLY SEEMS LIKE A GROWING
RESPECT FOR THIS IMPORTANT WORK
AND THIS APPROACH BECAUSE AS
KARLA SAID, OH, I'VE BEEN DOING
SOME OF THIS FOR A LONG TIME
WITHOUT REALIZING.
IT ALSO WASN'T VALUED IN CERTAIN
CORNERS OF SCIENCE BEFORE SO I
WANT TO SHOUT OUT EFFORTS TO
MAKE THAT IMPORTANT AND
RECOGNIZE THAT.
>> THAT'S A GREAT SEGUE TO
SOMETHING I WANTED US TO TALK
ABOUT.
SO YOU MENTIONED, YOU KNOW,
RESEARCHERS ARE ALWAYS SAYING
GOSH, PARTNERSHIPS ARE TIME
CONSUMES, YOU DON'T GET A
PUBLICATION OUT OF IT, THINGS
WE'RE HELD ACCOUNTABLE FOR.
AS MARY WAS SAYING WE'RE
STARTING TO SHIFT SOME OF THAT
IN SOME VALUES FOR THESE KINDS
OF EFFORTS.
NOW LET'S LOOK ON THE OTHER
SIDES OF OUR PARTNER SIDE.
NAN WAS TALKING ABOUT GETTING IN
SCHOOLS AND SO ON.
WHAT HAS BEEN YOUR EXPERIENCE
TRYING TO START UP PARTNERSHIPS?
SOMETIMES PARTNERS ARE NOT THAT
INTO YOU.
SOMETIMES EVEN IF THEY ARE
EXCITED ABOUT THE PROJECT, YOU
KNOW, A TEACHER OR AN SLP IN THE
SCHOOL DOESN'T HAVE 20 MINUTES
BUILT IN TO PARTNER AND BE
AVAILABLE TO YOU.
THEY ARE BEING ASKED TO DO THAT
IN SOME OTHER KIND OF WAY.
SO ANY THOUGHTS ABOUT THAT?
HOW TO NAVIGATE THOSE WATERS?
WHAT MIGHT HELP EASE THE BURDEN
FOR PARTNERS?
ANY OF THOSE KINDS OF ISSUES
THAT YOU COULD SPEAK TO.
>> AS A TRAINED CLINICAL
PSYCHOLOGIST LISTENING IS ONE OF
THE MOST IMPORTANT THINGS TO
START WHEN YOU'RE BEGINNING
THESE RELATIONSHIP WAS
STAKEHOLDERS.
AND HEARING WHAT THEY HAVE TO
SAY.
AND HOPEFULLY SHAPING THE
RESEARCH TO FIT THEIR NEEDS.
THAT'S THE BEST WAY FOR BUY-IN
BECAUSE THEN THEY ARE NOT GOING
TO FEEL LIKE THEY NEED TO DO
MORE TO BE PART OF THE RESEARCH
THAT THEY JUST ARE EXCITED TO BE
PART OF THE RESEARCH BECAUSE IT
HELPS ADDRESS SOME OF THE ISSUES
THAT THEY DEAL WITH.
I FOUND A LOT OF SUCCESS WITH
THAT APPROACH.
I THINK AT THE SAME TIME WE HAVE
TO KNOW WHEN TO STAND BACK.
SOMETIMES THERE ARE PEOPLE THAT
AREN'T INTERESTED.
THAT'S OKAY.
SOMETIMES THEY MIGHT TURN BACK
AROUND AND CHANGE THEIR MIND
DOWN THE ROAD.
STILL BEING OPEN MINDED ABOUT
THAT AND KNOWING WHEN TO STEP
BACK IS AN IMPORTANT PIECE AS
WELL.
>> GO AHEAD, KARLA.
>> TO ECHO DAN'S COMMENT RELATED
TO THAT AREA OF CULTURAL
HUMILITY, CULTURE IS AMONGST ALL
OF US SO BEING MORE OTHER
ORIENTED, LISTENING AND BEING
WILLING TO KNOW YOU'RE NOT
ALWAYS A TEACHER BUT THE
LEARNER.
IF THE COMMUNITY BELIEVES YEAR
HERE TO LEARN FROM THEM THEY ARE
MORE WILLING TO LET YOU IN
BECAUSE OH, I'M TEACHING YOU
SOMETHING THAT YOU DON'T KNOW.
AND THEN AS PART OF THE THAT
LISTENING YOU FIND THE GAP THEY
HAVE NOT BEEN ABLE TO FILL YET,
AND OFTENTIMES WHEN YOU GET THAT
ALIGNED WITH YOUR NEEDS, IT'S A
VERY SUCCESSFUL ENDEAVOR BECAUSE
IT BECOMES A WIN-WIN SITUATION.
SO IT'S NOT NEW WORK.
IT'S WORK THAT'S GOING TO BE
BENEFICIAL TO BOTH SIDES, WHILE
MEETING THE NEEDS ON BOTH SIDES
OF THE TABLE.
SO THAT'S MY COMMENT.
>> ANY OTHER THOUGHTS ON THIS?
GO AHEAD, MARY.
>> ONE THING THAT I -- I LOVE IT
WHEN YOU FIND IN IMPLEMENT
SCIENCE THE CHAMPION, RIGHT?
THAT'S YOUR CONNECTION THERE.
SO THINK ABOUT, YOU KNOW, THAT
DIFFICULT DISTRICT, I'VE GOT
SOME OF THOSE TOO.
IF YOU FIND THE RIGHT PERSON IN
THERE WHO IS SO, YOU KNOW,
PASSIONATE ABOUT THE PROJECT AND
WHAT NOT, SOMETIMES THEY WILL BE
ABLE TO OPEN DOORS THAT YOU
COULDN'T HAVE BEFORE.
AND SO REALLY FINDING THOSE
FOLKS AND FINDING WAYS TO
ELEVATE THEM AND EMPOWER THEM TO
REALLY TAKE THE LEAD ON THINGS,
THAT CAN BE FANTASTIC IF YOU'RE
LUCKY ENOUGH TO FIND THOSE FOLK.
>> GO AHEAD.
>> SOMETIMES THERE'S A LITTLE
LEVITY, I FIND ONCE YOU
UNDERSTAND THE CULTURE AND WHAT
THEY LIKE, YOU KNOW, SOME PEOPLE
THE WAY TO GET TO THEM IS
THROUGH THEIR STOMACH.
YOU DO IT OVER FOOD.
YOU OFFER FOOD.
USING FOOD, AFTER THAT THE
ENTIRE DEMEANOR CHANGES AND THEY
REMEMBER, OH, YOU WERE THE
PERSON THAT BROUGHT -- THEY
DON'T REMEMBER ANYTHING ELSE BUT
THE POSITIVE YOU BROUGHT THAT
FOOD AND IT GOES FROM THERE.
JUST LEARNING THE CULTURE AND
WHAT PEOPLE LOOK IS ALSO ANOTHER
WAY INTO THE DOOR TO GET THAT
CHAMPION.
>> THAT WAS A GREAT ARRAY OF
TIPS AND TRICKS.
I WANT TO -- WE HAVE A COUPLE
MINUTES LEFT IN THE PANEL.
I WANTED TO COME BACK TO
SOMETHING I THINK KARLA OR MAYBE
MARY, YOU'RE BOTH WORKING IN THE
SPACE OF PARTNERING WITH KIDS
AND UNDERSTANDING THEIR
EXPERIENCE, I IMAGINE A LOT OF
THE AUDIENCE THOUGHT, HOW DO YOU
WORK WITH A KID WITH
COMMUNICATION DISORDER AND TALK
TO THEM ABOUT THEIR
COMMUNICATION?
AND YOU ALL HAVE SOME DIFFERENT
TECHNIQUES SO I WONDERED IF YOU
COULD TOUCH ON THAT BRIEFLY, HOW
WE CAN GET THAT LIVED EXPERIENCE
FROM CHILDREN, WHAT MIGHT BE TE
WAYS TO DO THAT.
>> OKAY.
SO ONE OF THE TOOLS THAT I HAVE
USED IS DRAWINGS.
I KNOW THAT'S NOT -- REALLY,
DRAWINGS?
YES, WE DRAW WITH KIDS.
SOMETHING KIDS KNOW HOW TO DO
NATURALLY.
YOU PROVIDE THEM WITH THE TOOLS.
ONE THING WE DO DO, THE
INSTRUCTION IS -- TECHNIQUE IS
BASED ON SHARON MCCLOUD'S WORK
FROM AUSTRALIA, THE -- I'M
DRAWING A BLANK, THE AUSTRALIAN
DRAWING PROTOCOL I'LL CALL IT,
YOU ASK A QUESTION, SO TALKING
TO SOMEONE ELSE, HAND THEM A
PIECE OF PAPER WITH A SET OF
MARKERS.
THEY JUST GO AHEAD AND DRAW.
WE LEARN SO MUCH.
THEN YOU GOAT ASK CHILDREN
QUESTIONS ABOUT THEIR DRAWING.
YOU DON'T MAKE ASSUMPTIONS.
SEE WHAT YOU CAN GLEAN.
THE THINGS WE'VE LEARNED BY
ASKING QUESTIONS ABOUT THEIR
DRAWING, THERE'S GREAT SOCIAL
VALIDITY AND EXTERNAL VALIDITY.
ACTUALLY IT MIRRORS WHAT WE'VE
LEARNED FROM SOCIAL LINGUISTS
ABOUT LANGUAGE DEVELOPMENT IN
CHILDREN WITHOUT ASKING CHILDREN
A COMPLICATED QUESTION BUT A
QUESTION MORE RELATABLE TO THE
CHILD.
SO ONE WAY THAT'S DISARMING AND
EMPOWERING OF THE CHILD'S VOICE
TO USE DRAWINGS TO UNDERSTAND
THEIR TALKING EXPERIENCES EVEN
WHEN THEY CANNOT TALK IN SO MANY
WORDS THEMSELVES.
>> A HUNDRED PERCENT!
WE FOLLOW THE SAME PROTOCOLS.
AND ALSO BUILDING OFF DR.
WASHINGTON'S WORK WE BASE SOME
OF WHAT WE DO ON THE FOCUS, LOOK
AT THE QUESTIONS FROM THE FOCUS,
GEAR THEM TOWARDS THE KIDS AND
WE'VE BEEN USING A LOT OF, YOU
KNOW, RATING SCALES WITH HAPPY
FACES, EMOJI TYPES OF THINGS.
THAT WAY KIDS DON'T HAVE TO COME
UP I'M FEELING ANGST, THEY TOUCH
THE BUTTON.
THAT'S BEEN HELPFUL.
THE OTHER THING I WOULD
HIGHLIGHT THERE IS THE REAL NEED
TO DO PILOT WORK BECAUSE KIDS
ALWAYS -- ONE OF THE THINGS I
LOVE ABOUT WORKING WITH KIDS,
THEY ARE SURPRISING WITH HOW
THEY INTERPRET THINGS SOMETIMES.
SO DOING A LOT OF PILOT WORK TO
KIND OF MAKE SURE YOU'RE ASKING
THE QUESTION IN A WAY THAT MOST
KIDS ARE GOING TO UNDERSTAND THE
SAME WAY YOU INTENDED IS A BIG
ONE.
I WILL SAY WE HAVEN'T GOTTEN A
TON OF -- I DON'T KNOW IF WE'VE
GOTTEN AS MUCH FROM OUR DRAWINGS
AS SOME OTHER PROJECTS IN TERMS
OF CONTENT, BUT IT'S AN
EXCEPTIONAL WAY TO BUILD THE
RAPPORT.
STARTING OUT, YOU'RE BUILDING
THAT TRUST WITH THE CHILD,
GETTING USED TO THEIR PATTERNS
OF SPEECH, ALL THESE TYPES OF
THINGS, THOSE ARE SOME
TECHNIQUES WE'VE USED AND REALLY
ARE EXCITED TO ANALYZE THOSE
THINGS AND SHARE THEM.
>> ALL RIGHT.
GO AHEAD, NAN.
>> VERY FAST, MY OTHER DAY JOB I
DEAL WITH LITTLE CHILDREN WHO
STUTTER.
WE HAVE LOTS OF COMMUNICATION
ATTITUDES.
AND SELF-RATING SCALES IN THAT
FIELD.
AND MANY OF THEM ARE ACTUALLY
NORMED.
LIKE THE KITTY CAT, THE KITTY
COMMUNICATION ATTITUDE TEST,
OBVIOUSLY SOME QUESTIONS, ONE OR
TWO NOT APROPO TO A YOUNG CHILD
WHO DOES NOT STUTTER, BUT MANY
GIVE YOU GOOD INSIGHT INTO HOW
YOUNG CHILDREN FEEL ABOUT
TALKING AND COMMUNICATING,
GETTING THEIR POINT ACROSS, HOW
LISTENERS INTERACT WITH THEM.
SO IT'S JUST SOMETHING YOU MIGHT
CONSIDER LOOKING AT FOR A CHILD
WHO IS MORE VERBAL.
AND I WOULD SAY THAT ONCE YOU
DEAL WITH CHILDREN WHO ARE
HIGHLY VERBAL MAKING THEM A PART
OF IEP AND THAT PROGRAMMING IS
CRITICAL.
THEY HAVE TO BE PART OF THAT
PROCESS.
>> WONDERFUL.
THANKS SO MUCH.
THAT WAS REALLY GREAT.
HOPEFULLY THAT INSPIRES SOME
PEOPLE TO THINK OF DIFFERENT
WAYS TO COMMUNICATE WITH
CHILDREN.
WHILE WE PULL UP CLOSING SLIDES
JOIN ME IN THANKING OUR
PANELISTS, SPEAKERS, AUDIENCE
MEMBERS.
WE REALLY APPRECIATE YOU SHARING
YOUR WORK AND SHARING YOUR
THOUGHTS ON THESE IMPORTANT
ISSUES.
IN TERMS OF MIGHT HAVE OWN
CONCLUDING THOUGHTS I SPEAK FOR
ALL OF THE TALK TEAM IN REALLY
FINDING THAT WE'VE MAYBE JUST
SCRATCHED THE SURFACE OF SOME OF
THE ANSWERS TO THESE KIDS.
WE'RE VERY ENCOURAGED BY THE
ENTHUSIASM AND ENERGY AROUND ALL
THREE OF OUR TALK THEMES AND ALL
THE GREAT IDEAS AND
CONVERSATIONS THAT CAME UP
ACROSS THESE THREE WORKSHOPS.
SO OUR LEADERSHIP TEAM WILL
THINK ABOUT HOW TO SPARK
IMPORTANT CONVERSATIONS.
NEXT SLIDE.
WE ALSO WANT TO SPARK YOUR
RESEARCH BY GIVING YOU FUNDING.
BE SURE TO CHECK OUT OUR TALK
WEBSITE FOR SOME OF OUR CURRENT
FUNDING OPPORTUNITIES.
OUR PROGRAM OFFICERS ARE ALL
LISTED HERE AS WELL.
AND SO THAT WILL GIVE YOU SOME
IDEAS OF WHO TO TALK TO.
DON'T GET HUNG UP ON TRYING TO
FIGURE OUT WHO THE RIGHT PERSON
IS TO TALK TO.
ANY OF US ARE HAPPY TO TALK TO
YOU ABOUT TALK, NO DOOR IS THE
WRONG DOOR SO PLEASE DO
COMMUNICATE WITH US.
AND THEN THE NEXT SLIDE, SO
SADLY THIS IS OUR LAST WORKSHOP
FOR 2024.
I WANTED TO LET YOU KNOW WE HAVE
RECORDED ALL THREE WORKSHOPS AND
WILL POST RECORDINGS, EITHER ON
THE EVENT WEBSITE OR MAIN
WEBSITE, ON THE LAST SLIDE.
SO IF YOU MISSED ANY OF THEM,
YOU CAN CATCH THE RECORDINGS,
LOOK FOR THOSE ON OUR WEBSITE.
IF YOU WANT TO INVOLVE OTHERS
WHO WEREN'T ABLE TO COME, FEEL
FLEE TO SHARE THOSE RECORDINGS.
WE CAN GO TO THE END NOW.
SO ONCE AGAIN, THANK YOU TO
EVERYONE FOR JOINING US FOR THIS
WORKSHOP.
WE LOOK FORWARD TO CONTINUING
THE CONVERSATION WITH ALL OF YOU
AROUND THE TALK INITIATIVE.
[END OF PROGRAM]